Would you prefer to fill out this application over the phone? Please call our partners at The Alliance at (346) 396-6903, and say you'd like help completing the Connective Winter Storm Home Repair Application in English, Spanish, or Vietnamese. Other languages are also available through interpreters.

Important Information

Thanks for your interest in the Houston-Harris County Winter Storm Relief Fund's home repair program!

Please note that the successful submission of your application is not a guarantee of home repair assistance, and you may be asked to provide additional information at a later date.

Due to limited funding, our non-profit home repair partners will be prioritizing the following repair items:

  • Muck & gut/removal of damaged interior building materials
  • Proper preventative dry-out & water extraction of leak affected area
  • Plumbing repairs:
    • Achieve running water with no leaks
    • Replace essential fixtures (kitchen sink, toilet, shower/tub, hot water heater) if necessary
    • Interior water service only
    • Insulation of new pipes

Please enter the address of the home that was damaged by the 2021 Winter Storm and needs to be repaired. If you have already filled out a 2021 Winter Storm Home Repair application for this address, please stop here and email us at [email protected] for a status update.

Type your address and click on the matching result.











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Would you prefer to fill out this application over the phone? Please call our partners at The Alliance at (346) 396-6903, and say you'd like help completing the Connective Winter Storm Home Repair Application in English, Spanish, or Vietnamese. Other languages are also available through interpreters.

Respondent Information



















Primary Contact or Homeowner's Information








Page 3

Would you prefer to fill out this application over the phone? Please call our partners at The Alliance at (346) 396-6903, and say you'd like help completing the Connective Winter Storm Home Repair Application in English, Spanish, or Vietnamese. Other languages are also available through interpreters.

Household Demographics and Income



By age group, please account for all household members currently living with you at the home, including yourself.

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Would you prefer to fill out this application over the phone? Please call our partners at The Alliance at (346) 396-6903, and say you'd like help completing the Connective Winter Storm Home Repair Application in English, Spanish, or Vietnamese. Other languages are also available through interpreters.

Income Eligibility Information




$
per month
Please enter numbers only and round to the nearest dollar. Commas, decimals, and special characters (such as $) are not allowed.






Note: If you submit the application without submitting the required documents, Connective will follow up with you to submit them at a later time. The application will not be considered complete until we receive the documents.
Proof of No Income
Acceptable documents are documents demonstrating no income:

Proof of Salary/Wages
Acceptable documents are documents demonstrating income:
  • 2019 or 2020 tax return listing all adult household members
  • 2020 W2(s) for every job held by each adult household member
  • Unemployment compensation statement showing 2020 income
  • Paystubs for the last 30 days
  • Letter from employer verifying monthly salary/wages

Proof of Self-Employment Income
Please complete the following Profit and Loss Ledger and upload it below. If you have your own, you can also submit it below.

Proof of Unemployment Income
Acceptable documents are documents demonstrating unemployment income:
  • Current TWC unemployment check
  • Unemployment compensation statement
  • Letter from employer of termination from employment

Proof of Retirement and/or Pension Income

Proof of Social Security Income

Proof of SSI/Disability Income

Proof of Alimony and/or Child Support Income

Proof of Other Income
If you do not have a document that records your income, please complete the following Declaration of Income Statement and upload it below.

Home Condition and Ownership











Wavier



Connective Texts


Our Partners