Skip to form

City of Charlotte

600 East Fourth Street, Charlotte, NC, 28202, US


Lead Safe Program Pre-Application

The LeadSafe Program is a grant funded, housing program to address lead-based paint hazards found in older homes.  To determine eligibility, we will request income documentation after confirming other qualifications. Eligible beneficiaries are those that qualify with a household income under 80% Area Median Income (AMI).  These amounts change yearly.  The program will determine your eligibility after this screening process.

Full Name

Full Address

How did you hear about this program?

I understand that North Carolina Statute provides that willful false statements or misrepresentation concerning income; asset or liability information relating to financial condition is a misdemeanor of the first degree, punishable by fines and imprisonment provided under Statutes.  I further understand that any willful misstatement of information will be grounds for disqualification.  I certify that the application information provided is true and complete to the best of my knowledge.  I consent to the disclosure of information for income verification related to deciding of my eligibility for program assistance.  I agree to provide any documentation needed to assist in determining eligibility and are aware that all information and documents provided are a matter of public record. The City reserves the right to conduct criminal background checks on household members. Criminal convictions may not necessarily disqualify you from the program.

Sign Here

Choose how to sign