EXHIBIT OXHIBIT VV
SHIPROCK CHAPTER GOVERNMENT
POINT ALLOCATION SHEET
Applicant:
Category of assistance requested (A, B, C, or D):
Condition
Pts. Allocated
Applicant’s family size and household income.
Applicant’s living conditions.
Applicant needs repair or renovation.
Applicant is elderly, disabled or veteran.
Overcrowded condition.
Unsafe/unsanitary condition.
Total pts. allocated
Result:
Applicant is awarded. Award is in the amount of $
Applicant is awarded the amount of $
the eligibility amount because
Applicant is denied. Denial is due to
10
.
, which is less then
.
.
EXHIBIT OXHIBIT VV
Categories of Assistance
Note: All applications and related documents will be verified prior to approval or denial
of awarding assistance. Home visits will be conducted.
A. Assistance for
minor repairs.
The Shiprock Chapter will provide assistance for minor repairs of
maintenance to existing home of the applicant and applicant’s family.
Assistance will depend on availability of funds and be based on total
points.
Total Pts.
30
29
28
27
26
25
24
23
22
21
20
19
18
17
19
Amount
$1000.00
$971.50
$938.00
$904.50
$871.00
$837.50
$804.00
$770.50
$737.00
$703.50
$670.00
$636.50
$603.00
$569.50
$536.00
Total Pts.
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Amount
$502.50
$469.00
$435.50
$402.00
$368.50
$335.00
$301.50
$268.00
$234.50
$201.00
$167.50
$134.00
$100.50
$67.00
$33.50
$0.00
Minor repairs include: Includes replacing windows, doors, floor tile, and
roof patching. Repairs must be general in nature.
11
EXHIBIT OXHIBIT VV
B. Assistance for
major repairs
and addition(s) or
renovation(s).
The Shiprock Chapter will provide full or partial assist for major repairs or
additions to an existing home used by the applicant and applicant’s family.
Assistance will depend on availability of funds and be based on total
points.
Total Pts.
30
29
28
27
26
25
24
23
22
21
20
19
18
17
19
Amount
$5000.00
$4833.43
$4666.76
$4500.09
$4333.42
$4166.75
$4000.08
$3833.41
$3666.74
$3500.07
$3333.40
$3166.73
$3000.06
$2833.39
$1666.72
Total Pts.
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Amount
$1500.05
$1333.38
$2166.71
$2000.04
$1833.37
$1666.70
$1500.03
$1333.36
$1166.69
$1000.02
$833.35
$666.68
$500.01
$333.34
$166.67
$0.00
Major repairs include: Replacing the roof, wall, flooring, plumbing,
and electrical wiring. Bathroom additions, other room additions would
fall under this category.
Renovations include: Changing or replacing of windows, doors, walls,
etc. due to damage or are in need of repair.
12
EXHIBIT OXHIBIT VV
C. Assistance for
start-up costs for
new housing.
The Shiprock Chapter will provide full or partial assistance for start-up
costs of new housing that will be the applicant’s and applicant family’s
primary house. Assistance will depend on availability of funds and based
on total points.
Total Pts.
30
29
28
27
26
25
24
23
22
21
20
19
18
17
19
Amount
$1000.00
$971.50
$938.00
$904.50
$871.00
$837.50
$804.00
$770.50
$737.00
$703.50
$670.00
$636.50
$603.00
$569.50
$536.00
Total Pts.
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Amount
$502.50
$469.00
$435.50
$402.00
$368.50
$335.00
$301.50
$268.00
$234.50
$201.00
$167.50
$134.00
$100.50
$67.00
$33.50
$0.00
Start-up costs includes: Includes planning and designing; floor plans,
archeological clearances, environmental assessments, land
withdrawals, surveys and infrastructure. Determining square footage,
number of rooms, type of rooms. Electrical wiring and plumbing
assessments are allowed under this category.
13
EXHIBIT OXHIBIT VV
D. Partial
assistance for
construction of
new house.
The Shiprock Chapter does not have the resources to provide full
assistance for the construction of new housing. The Shiprock Chapter can,
however, provide partial assistance for construction of new house. The
house will be the applicant’s and applicant family’s primary house.
Assistance will depend on availability of funds and be based on total
points.
Total Pts.
30
29
28
27
26
25
24
23
22
21
20
19
18
17
19
Amount
$7000.00
$6766.57
$6533.24
$6299.91
$6066.58
$5833.25
$5599.92
$5366.59
$5133.26
$4899.93
$4666.60
$4433.27
$4199.94
$3966.61
$3733.28
Total Pts.
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Amount
$3499.95
$3266.62
$3033.29
$2799.96
$2566.63
$2333.30
$2099.97
$1866.64
$1633.31
$1399.98
$1166.65
$933.32
$699.99
$466.66
$233.33
$0.00
New construction includes: House foundation, footing, concrete
pouring, cinder blocks, sealer, stem wall, roofing, roof decking, roof
material, exterior wall, windows, doors, electrical rough-ins, plumbing
rough-ins, insulation, drywall, plastering, E/P trim-out.
14
EXHIBIT OXHIBIT VV
Applicant’s living condition:
Pts.
No running water (plumbing), no electricity (wiring), and no heating system ...............
Electricity available, but no running water (plumbing) and no heating system ...............
Electricity and heat available, but no running water .......................................................
Electricity and running water available, but no heating system ......................................
Running water and heat available, but no electricity ......................................................
Running water, electricity and heat are unavailable ........................................................
5
4
3
2
1
0
Applicant needs repair or renovation:
Pts.






Repairs to five sections: roof, floor, walls, plumbing and wiring (e.g., bathroom) ..
Repairs to four sections: roof, floor, walls, plumbing or wiring ...............................
Repairs to three sections: roof, floor, walls, plumbing or wiring ...............................
Repairs to two sections: roof, floor, walls, plumbing (or bathroom) or wiring .........
Repair to one section: roof, floor, wall, plumbing or wiring .....................................
Needs no repair ...........................................................................................................
OR
Addition that will require renovation to:
5
4
3
2
1
0






5
4
3
2
1
0
All five sections: roof, floor, walls, plumbing and wiring (e.g., bathroom addition)
For of five sections: roof, floor, walls, plumbing or wiring .......................................
Three of five sections: roof, floor, walls, plumbing or wiring ..................................
Two of five sections: roof, floor, walls, plumbing or wiring ...................................
One of five sections: roof, floor, walls, plumbing or wiring .....................................
Does not need addition ..............................................................................................
Applicant is elderly, disabled, veteran and/or unemployed:





Pts.
Elderly, disabled, veteran ...........................................................................................
Elderly, disabled, non-veteran ....................................................................................
Disabled, veteran, non-elderly....................................................................................
Elderly, not disabled, non-veteran ..............................................................................
Not elderly, no disability, non-veteran .......................................................................
Pts.
5
4
3
2
1
Definitions:




Elderly means being 55 years of age or older.
Disabled means degree of physical and/or mental impairment of the individual. The
disability is verified by a physician.
Veteran means having served in the military services and honorably discharged.
Employed shall mean employment of a permanent nature or at least 7 months of each year
for the past years.
15
EXHIBIT OXHIBIT VV
Overcrowded conditions:
No of rooms in
dwelling
(excludes
closets,
bathroom and
kitchen).
Number of household members
6 or more individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
3 individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 or more individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
4 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 or 2 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 or more individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
5 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 or less individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 or more individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
6 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 or less individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 or more individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
7 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5 or less individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11 or more individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
8 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7 individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 or less individuals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
Pts.
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
EXHIBIT OXHIBIT VV
Type of unsafe/unsanitary condition:
Pts.
 Whole house is condemned or should be condemned due to major construction deficiencies
5
and/or deterioration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 Part of the house is condemned or should be condemned due to construction deficiencies and/or
4
deterioration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 Mold, mice infestation, or other health-related risk conditions exist within the house that will
3
require temporary displacement or relocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 Construction deficiencies exist that will require temporary displacement or relocation for repair or
2
renovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 Deficient plumbing, wiring, heating or other construction deficiencies exist within the house.
These construction deficiencies can be resolved within a timely manner (e.g., within several days)
1
without displacement or relocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 There are no unsafe/unsanitary conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0
17
EXHIBIT OXHIBIT VV
Applicant’s family size and household income.
Number of
Family Members
1
2
3
4 or more
Income
11,638 or less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11,639 to 14,547 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15,548 to 17,456 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17,457 to 20,365 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20,366 to 23,276 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23,277 or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15,613 or less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15,614 to 19,515. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19,516 to 23,417. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23,418 to 27,319. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27,320 to 31,226. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31,227 or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19,588 or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19,589 to 24,485. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24,486 to 29,382. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29,383 to 34,271. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34,272 to 39,176. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
39,177 or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23,563 or less. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23,564 to 29,454. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29,455 to 35,345. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
35,346 to 41,236. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
41,237 to 43,564. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43,565 or more. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
Pts.
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0
5
4
3
2
1
0