Rental Assistance Programs Forms

Filling out forms


Community Access Team (CAT)

Briefing Packet (Spanish)
Briefing PowerPoint Spanish
Community Access Team Voucher Application (Spanish
Debts Owed to DOH
Certification of Housing Quality Standards CAT
Mutual Rescission of Lease
Rental Assistance Document (RAD)
Request for Tenancy Approval (RFTA)
Statement of Understanding
Security Deposit Complete Packet 
Security Deposit Request Form

Family Self Sufficiency (FSS)

Escrow Distribution Checklist
Escrow Ledger
Escrow Worksheet
Participant Monthly Report
Participant Sign-Up Steps
Pre-Enrollment Form

Family Unification Program (FUP)

Program Agreement
Verification of Inadequate Housing

General Forms

PBV Tenancy Addendum
PBV Statement of Family Responsibility
PBV Rent Reasonableness
30-Day Notice
Action Identifier and Verification Checklist
Authorization for the Release of Information - DOH
Briefing Packet All Programs (Spanish)
Certificate of Relinquishment
Co-Head Declaration
HAP Assumption Agreement (Change in Owner)
Declaration of 214 Status
Disability Status Verification
Family Reporting Form
File Order Divider Sheets - Two Part Files
File Order Divider Sheets - Four Part Files
File Order Divider Sheets - Six Part Files
Forms Checklist
Housing Discrimination Complaint Form (HUD 903.1)
HUD 9886 - Privacy Act/Authorization to Release Information
In-state Transfer Form
Landlord Obligations
Mutual Rescission of Lease
Not Contending Residency Status
Notification of Client Move
Participant Conference Acknowledgement
Participant Conference Letter
PBV Transfer Request
Program Comparison Chart
Rent Reasonableness Form
Repayment Agreement Letter
Repayment Agreement Request for Lower Monthly Payment
Repayment Agreement Worksheet
Request for Tenancy Approval (HUD 52517)
Request to Add/Remove Family Members
Shared Housing Calculation Worksheet
Statement of Understanding
Student Status Verification
Termination Review Checklist
Violence Against Women Act (VAWA) Certification Form (HUD 5382)
Violence Against Women Act (VAWA) Notice of Occupancy Rights Form (HUD 5380)
W-9 Form
Zero Income Reporting Form

Housing Choice Voucher (HCV)

50058 - Fillable
50058 - FSS
50058 - Hand Calculate Fillable
50058 - Homeowners
50058 - Mixed Family
Debts Owed Notice (HUD 52675)
EID information sheet
HAP Contract -HCV (HUD 52641)
HAP Contract -Manufactured Home Lot Rent
Out Of State Portability Form
Statement of Homeowner Obligations - DOH
Statement of Homeowner Obligations (HUD 52649)
Supplement to Application (HUD 92006)
Tenancy Addendum: HCV
Tenancy Addendum: Manufactured Home Lot Rent
Voucher (HUD-52646)
What You Should Know About EIV

Housing Quality Standards

Carbon Monoxide Alarm Checklist
Fail Extension - Landlord
Fail Notice
Long Form (HUD 52580 a)
Short Form (HUD 52580)
Lead-Based Paint Disclosure

Income Calculations/Verification

Employment Verification
Verification of Self Employment
Income Calculation Form
Medical Calculation Form
Medical Expenses Verification
Verification of Nonwage Income and Assets

Continuum of Care Permanent Supportive Housing

Flowchart of Chronic Homelessness Definition
CoC PSH Referral Cover Sheet (Agency Use Only)
HMIS Client Release of Information
HMIS Intake Form
HMIS Assessment Form
HMIS Child Intake Form
HMIS Exit Form
Chronic Homelessness Verification
Chronic Homelessness Documentation Packet
Verification of Disability/Handicapped Status
Declaration of 214 Status Form
Authorization for Release of Information - DOH
Authorization for Release of Information - HUD
Zero Income Reporting Form
Family Reporting Form
Supplement to Application
50058: Permanent Supportive Housing
50058: Hand Calculate PSH
Certificate of Relinquishment
HAP Contract - PSH
Rental Assistance Document
Permanent Supportive Housing Briefing Packet
Permanent Supportive Housing Termination Checklist
Certification of Permanent Supportive Housing Briefing
Security Deposit Complete Packet
Security Deposit Form

Reasonable Accommodations

Live-in Aide Reasonable Accommodation Packet
Reasonable Accommodation Information Sheet
Reasonable Accommodation Request
Reasonable Accommodation: Verification of Continued Need
Reasonable Accommodation: Verification of Need
Rent From Relative

Section 811 PRA Forms

Model Documents from HUD

Rental Assistance Contract Part I
Rental Assistance Contract Part II
Required Section 811 Model Lease
Use Agreement
PRA Program Environmental Review Record Checklist

Other Links

HUD - Section 811 Project Rental Assistance
HUD - Section 811 Project Rental Assistance FAQs
TAC Resource Center on Supportive Housing - HUD Section 811 Program Information
DOH Section 811 PRA Information Sheet
Spanish Forms

Briefing Packet All Programs
HAP Contract: HCV (HUD 52641)
Housing Discrimination Complaint Form (HUD 903.1a)
Request for Tenancy Approval (HUD 52517)
Statement of Homeowner Obligations (HUD 52649)
Violence Against Women Act (HUD 50066)
Voucher (HUD-52646)

State Housing  Voucher (SHV)

Certificate of Relinquishment
Certification of SHV Briefing
HAP Contract - SHV
Rental Assistance Document
Security Deposit Complete Packet
Security/Damage Deposit Form (SHV Only)
Statement of Understanding
State Housing Voucher Request for Subsidy Type Transfer
State Housing Voucher Termination Checklist
Verification of Disability/Handicapped Status

Tenant Based Rental Assistance (TBRA)

50058: TBRA
Authorization for Release of Information
Certificate of Relinquishment
Certification of TBRA Briefing
HAP Contract
HOME Lease Addendum
Mutual Rescission of Lease
Rent Reasonableness
RFTA Cover Page
Security Deposit Form (TBRA Only)
Statement of Understanding
Termination Checklist
Verification of Inadequate Housing​​​​​​