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2021 Winter Storm
Home Repair & Reimbursement Application

As of August 19, 2021, this application is for both home repair and reimbursement requests. related to the winter storm. On page 2, you'll be asked to specify which type of assistance you're seeking.

If you have questions about an existing application, please email [email protected] with your name and address.

If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.

Please enter the address of the home that was damaged by the 2021 Winter Storm and needs to be repaired.

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

Note: Reimbursement is only available for homes in the City of Houston or Harris County. Repair is available to homes in the City of Houston, Harris County, or Fort Bend County.

Type your address and click on the matching result.















If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.

Reimbursement Program

If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.
Important Information About The Reimbursement Program

The Winter Storm Reimbursement Program is funded by the Houston-Harris County Winter Storm Relief Fund.

To be eligible for reimbursement, applicants must meet these requirements:

  1. The home was damaged by the Winter Storm in February 2021.
  2. A member of the household paid to make repairs to the home.
  3. The home is located in the City of Houston or Harris County.
  4. A member of the household owns the home or has a clear path to owning the home.
  5. The same household lived in the home prior to the Winter Storm in February 2021.
  6. The household's current income must be under 120% of AMI ($95,050 for four-person household).

Eligible applicants may be eligible to receive up to $5,000 per household for qualifying expenses.
After you submit your application, our team will work with you to verify your winter storm home repair expenses. So we can do this, please share some more information about these expenses.
Your Reimbursement Request




Reimbursement Verification Options
Next, we need to verify that these repairs were completed and that you paid for them. There are two ways we can do this:

Option 1 - You can upload receipts or other valid proof of payment documents (account statements, paid invoices from a contractor, etc.).

-OR-

Option 2 - A vetted nonprofit called The Restoration Team can visit your home to confirm which repairs have been completed.

Option 1 - Upload Receipts or Other Proof of Payment
Please upload all proof of payment documentation related to your reimbursement request.

We accept any of these documents dated on or after Feb. 22, 2021 with the vendor name clearly written:
  • Receipts (or invoices marked as paid)
  • Bank statements (credit card or debit card/checking account)
  • Check photocopies
  • Email, fax, or written letter from vendor confirming payment
Please note: We may ask for further documentation, like photos or a signed statement from you.


That's OK! You can submit an application without uploading documents. Our team will work with you to collect and verify them once you've successfully submitted an application.
Option 2 - Request a Home Visit to Verify Repairs Made
In order to verify that repairs were made, a vetted nonprofit called The Restoration Team will visit and inspect your home.

Once you submit your application and it has been reviewed, The Restoration Team will contact you to schedule an appointment within 60 days.



Repair Program

Keep Going!
Thanks for filling out the section for your reimbursement request. Please continue with your repair assistance application. We will not receive your information until you click the submit button on the final page.
If you need assistance filling out this application over the phone, please call (713) 862-8222 for speak with a representative in English or Spanish.
Important Information About The Repair Program

Our repair program is funded by the Houston-Harris County Winter Storm Relief Fund and Fort Bend Recovers.

Please note that the successful submission of your application is not a guarantee of home repair assistance or reimbursement, 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









Respondent Information

If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.
Respondent Information



















Primary Contact or Homeowner's Information








Household Information

If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.
Household Demographics and Income



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

Income Eligibility

If you need assistance filling out this application over the phone, please call (713) 862-8222 to speak with a representative in English or Spanish.
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.

Wavier

If you need assistance filling out this application over the phone, please call (713) 862-8222 for speak with a representative in English or Spanish.


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