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EXHIBIT D <br />RANCHO/MILL HOME BEAUTIFICATION GRANT <br />REQUEST FOR REIMBURSEMENT <br />Homeowner <br />Address <br />Approved Grant Amount — these funds may be taxable, you should consult with your tax <br />advisor prior to submitting Requests for Reimbursement. <br />Grant Funds Reimbursed <br />Remaining Grant Funds Available <br />Approved Improvements (Any deviations from this description will not be covered Under the Grant program <br />finless prior written authorization is received from the Agency.) <br />Above Office Use Only <br />Please complete the following when submitting your request: <br />Improvements Completed for which reimbursement is being requested: <br />Amount of Reimbursement Requested (must be no more than 66.6% of invoice or receipts) <br />Payment Method — Please allow 3 weeks <br />Please check one <br />Please issue a 2 —party check, made payable to the applicant and Contractor (invoice attached). <br />Please issue a check made payable to the Homeowner. The Contractor has already been paid (the <br />invoice attached is marked "paid"). <br />