Rp Form 19-53(H) Affordable Rental Housing Application Page 2

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TO QUALIFY FOR BENEFITS UNDER THIS PROGRAM. THE OWNER(S) SHALL SUBMIT AN EXECUTED
COPY OF THE RENTAL AGREEMENT (MUST BE 6 MONTHS OR LONGER) AND/OR OTHER DOCUMENTS
AS PROOF OF RENTAL CHARGES.
For the period of this application, the Affordable Rental Housing Rates are as follows:
STUDIO
ONE
TWO
THREE
FOUR
FIVE OR MORE
BEDROOM
BEDROOMS
BEDROOMS
BEDROOMS
BEDROOMS
$ 562
$ 749
$ 903
$ 1,052
$ 1,344
$ 1,545
Below are rental rate exceptions for the following Zip Codes: 96719, 96725, 96738, 96739, 96740, 96743,
96745, and 96755:
STUDIO
ONE
TWO
THREE
FOUR
FIVE OR MORE
BEDROOM
BEDROOMS
BEDROOMS
BEDROOMS
BEDROOMS
$ 659
$ 788
$ 974
$ 1,642
$ 1,887
$ 1,284
SUBMIT APPLICATION FORM WITH SUPPORTING DOCUMENTATION TO:
Real Property Tax Division
HILO
KONA
Aupuni Center
West Hawai‘i Civic Center
101 Pauahi Street, Suite No.4
74­5044 Ane Keohokalole Hwy.
Hilo, Hawai‘i 96720
Bldg.D, 2ndFlr.
KailuaKona, Hawai‘i 96740
Application forms are available at the Real Property Tax Division Hilo Office, Kona Office, or the website at
PLOT PLAN
If there is more than one dwelling unit on the property, then, draw a plot plan (please show dwelling location along
with date built, approximate size, one or two story and adjacent roadway). Designate which building is your residence.

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