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Find similar grantsLead Hazard Reduction Program is sponsored by Cook County Department of Public Health. Free lead hazard reduction services for eligible homes in suburban Cook County built before 1978.
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Cook Count y Department of Public Health – Lead Hazard Reduction Grant Time Verification Form – Visiting C hild Instructions for completing this form: -Complete this form for a visiting child under the age of six (6) years.
Adult Name: ______________________________________________________________________ Address: ____________________________________________________________________ I verify th at the child (name of child) __________________________________________, (child ’s relation ship to y ou ) __________________________________ spends a significant amount of time in my unit.
Please use the chart below to indicate approximately how many hours each day the child visits/spends time at the unit: > Time child visits 2:30 -5:00 > Sunday Monday Tuesday Wednesday Thursday Friday Saturday I verify that the information I provided is accurate. I understand that this information will be used, in part, to determine program eligibility.
I understand that providing untrue or misleading information could result in the denial of my application or my removal from Signature of applicant: _____________________________________________________________ Date: _____________________________________
According to the current listing, eligibility includes: Homeowners and renters in suburban Cook County residing in single-family homes or 2-4 unit buildings built before 1978. Confirm the full requirements in the official notice before applying.
Lead Hazard Reduction Program is funded by Cook County Department of Public Health. Verify program details on the funder's official page before applying.
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