Please complete this simple pre-application form and our staff will review your information to ensure you meet program qualifications.  Stay tuned, if you are eligible for this program, we will contact you shortly.

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Once it is confirmed you meet program qualifications, you will be asked to fill out and submit a full application.  Download the appropriate application below.

• Application for owner-occupied property
  

  English Application 

  Spanish Application 

• Application for rental property

  English Rental Application

  Spanish Rental Application 

You can submit completed applications via mail, fax, email, or feel free to hand-deliver to the Lead Safe Housing Program:

2001 S. State Street, Suite S2-810
P.O. Box 144575
Salt Lake City, UT 84114-4575
Fax: 385.468.4894
cdyksman@slco.org

Reminder: please remember to include proof of income for all household members 18 years and older.

Questions? 
Phone: 385.468.4892 
Español: 385.315.0049