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*We are experiencing a very high volume of applications for rental assistance at this time.
Because of this, it may be a few weeks before we are able to get you in for an appointment if you are deemed eligible. We are not able to provide emergency same day or same week assistance at this time.
Please do not apply if this timeframe does not work for your situation.
If you do not wish to continue, please exit this page.
Applicants are bound by the information presented in this application and, by submitting the application, confirm that all information provided is true and accurate. False information will result in denial of assistance and any other applicable consequences.
Failure to provide accurate, appropriate information may result in denial of your application.
Efficiency or Studio: $560
One Bedroom: $600
Two Bedroom: $720
Three Bedroom: $831
Four Bedroom: $927
This form must be completed in its entirety in order for us to consider your application for assistance. Assistance is not guaranteed by submitting this form.
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Your current city.
List all other household members BUT NOT yourself. This includes children.
Indicate this person's relationship to the primary applicant.
For this section, please answer each question honestly and accurately. Gross income refers to the amount before taxes and other items are deducted from your check. Whenever possible, please use exact paystub or statement amounts to provide an accurate total income for each source. Each source of income will have to be verified with paystubs or current statements prior to assistance.
Money or income refers to income from employment, social security, child support, unemployment, or any other source of financial benefits except for food stamps.
If someone in the home is employed currently, please provide employment details such as employer, hourly/salary wage, hours per week, which household member works, and employer contact information here.
Please be as accurate as possible. Gross income means BEFORE any taxes or deductions are taken out.
Please be as accurate as possible. Gross income means income or benefits BEFORE any taxes or deductions are taken out. Please include income from all household members.
Please be as accurate as possible. Gross means income or benefits BEFORE any taxes or deductions (such as medicare/medicaid premiums) are taken out - which means this amount may be more than what you actually get. Please include income from ALL household members.
Please be as accurate as possible. Gross income means income or benefits BEFORE any taxes or deductions are taken out of the check. Please include income from all household members.
Please be as accurate as possible. Gross income means income or benefits BEFORE any taxes or deductions are taken out of the check. Include sources of income from all household members.
This means a WRITTEN notice from your landlord/property manager stating that you must vacate the residence.
We will contact the landlord, so please be honest!
We ask that you please discuss this with your landlord prior to completing this application. There is nothing we can do if the landlord won't work with us.
Please provide as much detailed information as possible about your current circumstances, including the reason you have fallen behind in your rent and any other information you would like to provide.
You may submit any supporting documentation you feel may be helpful.
YOU MAY BE DIRECTED TO A PAGE ONCE YOU CLICK SUBMIT THAT SAYS YOU ARE INELIGIBLE. This means that, based on your answers on this application, you would not qualify for assistance through one of our current programs. Do not attempt to resubmit an application with different information, unless you are certain you made a mistake the first time.
YOU MAY BE DIRECTED TO A CONFIRMATION PAGE ACKNOWLEDGING THAT WE HAVE RECEIVED YOUR APPLICATION. If this is the case, we will most likely respond to your application via the email address you put on the application. PLEASE check your email before calling to follow up.
This field is not part of the form submission.
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