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2. Name
4. Property Address
6. Phone Number
7. Email Address
9. Year Built
10. Total Units
11. Number of Occupied Units
12. Number of Vacant Units
14. Unit Number
15. Head of Household
16. Number of Occupants
17. Children Under Six Present*

    1. yes
    2. No
19. HUD 2020 INCOME LIMITS
    
21. Are your mortgage payments up to date?

    1. Yes
    2. No
23. Are the water and sewer bills for all Nashua properties which you have a financial in interest up to date?

    1. Yes
    2. No
25. Are real estate taxes on all Nashua properties which you have a financial in interest up to date?

    1. Yes
    2. No
27. Are there any liens against this or any Nashua property you have a financial interest in?

    1. Yes
    2. No
28. If yes, explain:
30. Have you been ordered to correct lead hazards by the State?

    1. Yes
    2. No
32. Do you authorize us to communicate with the State regarding the status of this property?

    1. Yes
    2. No
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field