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DocuSign Envelope ID:24839407-DB2D-47A2-B399-3BEA061662C1 t A - continued <br /> Provider's Outside Agency Application <br /> MAIN APPLICATION <br /> Chapel Hill Public Housing Residents See note 1 <br /> Orange County 55 69 75 <br /> Raleigh <br /> Wake County <br /> Total 250 265 290 <br /> Income Level —See following chart <br /> (Omit for HS) See note 2 <br /> < 30%Area Median Income <br /> 31-50% Area Median Income <br /> 51-80% Area Median Income <br /> > 80%Area Median Income <br /> Total 0 0 0 <br /> Special Needs (Omit for HS) <br /> Elderly(Over 62) <br /> Disabled (not elderly) <br /> Homeless <br /> People with HIV/Aids <br /> Total 0 0 0 <br /> NOTE 1 : We don't capture tf-fls data currently, but we do deHver to pubk houshig. (We <br /> deHver to the South Estes apartments and Trirflty Court) We also deHver to some dents <br /> who tell us they are Sedon 8 resdents. <br /> NOTE 2: We charge on a sldng scale based on monthly ncome and n 2015 137 of the <br /> 265 people we served were under 30% of arealmethan ncome. <br /> Main Application 5/24/2016 9:18:54 AM F a g :!!; 1 0 of 2 4 <br />