Sign Up for Home Repairs

Home Repair Intake Form

If you are a low-income homeowner in Breathitt, Knott, Leslie, or Perry County, KY in need of affordable home repairs, please complete the form below.

When we have received your submitted form, a member of our staff will contact you ASAP to get further info and will send you a checklist of information needed by postal mail. You’ll need to gather all the documentation requested in the checklist and return it as soon as you can by postal mail (mail to Housing Development Alliance, Inc., c/o Rebekah Vermillion, P.O. Box 7284, Hazard, KY 41702); or bring it with you to a scheduled in-person meeting with our Home Repair staff.

Once the documents have been received, we will begin to check your eligibility and will update you on your qualification status as soon as possible. If you have questions, call us at 606-436-0497.

Step 1 of 5 - Personal Information