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2. Welcome Home to Story County, Iowa

   Welcome Home to Story County Relocation Assistance Program allows up to $3,000 in relocation assistance. 

4. Eligible Applicants Must Meet All The Following Criteria:
   • Be employed in a full-time position within Story County;
   • Apply to the Welcome Home to Story County Relocation Assistance Program within 24 months of moving to Story County;
   • Be relocating to Story County as the primary residence;
   • If purchasing a home, real estate being purchased must be located in Story County;
   • Be discharged under honorable conditions.
5. The Following Items Are Eligible for Use of the Funds
   • Moving expenses
   • Purchases of appliances
   • Utility deposits
   • Down-payment assistance (for home purchases)*
   • Rent for temporary housing while waiting for permanent housing^
   • Rent deposits^
   • Rental assistance^

   * Funds used for down-payment assistance for the purchase of a house are distributed directly from Story County to the lender at the time of closing.

   ^ Story County may assist with rental assistance up to $3,000 for eligible applicants. In all cases of rental assistance, funds are payable directly to the leasing agent/landlord. 

9. Welcome Home to Story County, Iowa - Home Base Iowa Application
11. First Name*
12. Last Name*
14. Email*
15. Phone Number*
17. Street Address*
18. Mailing Address
20. City*
21. State*
22. Zip*
24. Is this your primary address?*

    1. Yes
    2. No
28. Employer Company Name*
29. Employer Address Within Story County*
31. City*
32. State*
33. Zip*
35. Work Phone Number*
36. Is this a full time job position?*

    1. Yes
    2. No
37. Proof of Employment*
41. Type of Request (please select all applicable):*

    1. 1. Moving expenses
    2. 2. Purchase of appliances
    3. 3. Utility deposits^
    4. 4. Rent for temporary housing (while waiting for permanent)^
    5. 5. Down-payment assistance (for home purchases)*
    6. 6. Rental assistance^
42. Please list your request $ amount for EACH type of request you selected*

    Example
    1. $ amount
    2. $ amount
    3. $ amount
    4. $ amount
    5. $ amount
    6. $ amount

43. * Funds used for down-payment assistance for the purchase of a house are distributed directly from Story County to the lender at the time of closing.

    ^ Story County may assist with rental assistance up to $3,000 for eligible applicants. In all cases of rental assistance, funds are payable directly to the leasing agent/landlord. 

45. Attach Receipts
46. Attach Receipts
47. Attach Receipts
48. Attach Receipts
50. Please fill the following information if you are making a requests of 3, 4, 5, 6
52. Lender or Leasing Agent/Landlord Name
54. Lender or Leasing Agent/Landlord Address
56. City
57. State
58. Zip
60. Attach Completed Rental Verification Form

     Download HBI Rental Verification Form

61. Rental Owner's Individual or Business W-9
65. Date of Military Discharge*
67. Please submit a SCANNED copy of DD-214 Military Discharge Paperwork*
69. Would you consent to giving a testimonial or being photographed if application is funded?*

    1. Yes
    2. No
71. With this application, I understand I will also need to complete a form W-9 and further understand the reimbursement may be considered income by the IRS*

    1. Yes
    2. No
73. If reimbursement, attach YOUR completed W-9

    (Fillable W-9 Website https://www.irs.gov/pub/irs-pdf/fw9.pdf )

75. Sign Name*
76. Date*
78. THANK YOU FOR APPLYING TO OUR STORY COUNTY RELOCATION ASSISTANCE PROGRAM

    Your application will now be reviewed, which can take 3-5 business days. Please make sure that you have submitted/attached ALL needed documents to your specific request. We may reach out to you if we need more information. This may delay the review/payment process.

    If you have any questions, please contact Sandra King, Director of External Operations at 515-382-7243.

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80. 1. Receive an email copy of this form.
81. Email address

    This field is not part of the form submission.

82. Submit

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