38 U S C Section 2101(a) or 2101(b))-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your First Name, Middle Initial, and Last Name in the designated fields.
3. Provide your Social Security Number in the appropriate section to ensure proper identification.
4. Fill in your Date of Birth using the MM/DD/YYYY format for accurate record keeping.
5. Enter your Email Address to facilitate communication regarding your application.
6. Complete the Address section with your full address, including City, State, and ZIP Code.
7. Input your telephone numbers: Daytime, Evening, and Cell, ensuring you include area codes.
8. Indicate if you have made a previous application for specially adapted housing by selecting 'Yes' or 'No.' If 'Yes,' provide the date and place.
9. Answer whether you have applied for a home improvement grant previously and provide details if applicable.
10. State if you are confined to a nursing home or medical care facility and include the name and address if applicable.
11. Use the Remarks section for any additional information that may support your application.
12. Sign and date the form at the bottom to certify that all information is accurate before submission.

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