Home Repair Form

Please fill out the online form, and then submit the following information:

  • Most recent 4 paystubs, SS/Retirement Statement, etc. from ALL income sources 18 yrs old and older in the household
  • Most recent statements (not letters or overdue bills) from ALL bills, even if they are annual or semi-annual (rent/mortgage, car payments, insurances (home, life, auto), tv, phone, internet, water/sewage, child care, real estate taxes, credit card payments, loan payments, electric/gas, etc).
  • A copy of your current homeowner’s insurance with premium

The items above can be submitted by:

Fax: 301-698-1697

Email: coralynn.wells@frederickhabitat.org

Mail or Drop Off:
Habitat for Humanity of Frederick County
24 S. Wisner Street, #130
Frederick, MD 21701