First and Last Name *

Email *

Phone *

Address Line 1 *

City *

Postal Code *

Housing Assistance Requested (Maximum of $1,000) *

Applications are reviewed by a subcommittee and the staff of the Kentucky REALTORS® Relief Foundation. Grants are awarded with a maximum of $1,000 in housing assistance or one month of mortgage/lease/lodging payments (not to exceed $1,000). For example, if your monthly mortgage payment is $1,500, your maximum requested amount is 1,000. 

Describe Damage to Property *

Please Indicate Type of Assistance Sought *

Please select the type of housing assistance. If yours is not listed, please enter it in the empty field above the Mortgage Payment (Primary Residence) field and hit ENTER.

Enter required value Mortgage Payment (Primary Residence) Rental Cost (Temporary Housing) Hotel/Lodging I Own My Home Outright

Please Upload One or More of the Following *

Enter required value Photos of Damages Insurance Estimate Copies of Written Claims, Settlement Proceeds, or Claim Status Reports Copies of Repair Estimates from Contractors

Upload *

Please upload the file from the option previously selected.

20MB max

Please Upload Your Mortgage Statement, Deed, or Current Lease Agreement *

Please Upload Your Mortgage Statement, Deed, or Current Lease Agreement.

20MB max

Street Address of Damaged Property *

Total Cost of Damage *

Type of Dwelling *

Please select your housing type. If yours is not listed, please enter it in the empty field above the Single Family field and hit ENTER.

Enter required value Single Family Condo/Townhouse

Upload Photo ID *

Please upload photo identification to show proof of residency. 

20MB max