2020 POINT IN TIME AGENCY FORM
2020 POINT IN TIME SURVEY FORM
Income guidelines:
To qualify, household income must meet the following income limit:
2020 Income Limits
ESG – At or below 30% of AMI
SSVF(Veterans) – At or below 50% of AMI
ESG
ESG Case File Sequence
VAWA lease addendum SAMPLE
VAWA lease Addendum SAMPLE 2
Prescreen Forms
Please utilize the coordinated entry process. All prescreens are required to be entered into Client Track.
Intake Documents
TCHSC Intake Form
New Housing plan- Budget
Client Consent Forms
Client Consent for Data Collection
Release of Information – Financial
Rent Reasonableness
2020 Rent Reasonableness-MC
2020 Rent Reasonableness-SLC
2020 Rent Reasonableness-IRC
Utility Allowance
Indian River County Apartment
Indian River County Single-Family
St. Lucie County Apartment
St. Lucie County Mobile Home
St. Lucie County Single-Family
Martin County Apartment
Martin County Single-Family
Request for Funds
Request for Funds
Inspection Forms
Habitability Standards
Lead-Based Screening
Landlord/Utility Documents
Current Landlord Information
New Landlord Information
Utility Worksheet
SSVF SPECIFIC FORMS
Case File Tool
VETERAN STATUS
SSVF Pending Verification of Veteran Status – Fillable
Guide for Pending Verification of Veteran Status
HOUSING STATUS
Literally Homeless Certification – Fillable
Literally Homeless Self-Certification – Fillable
Self-Declaration of Housing Status – Fillable
HP Prevention Screening Form – COMPANION GUIDE
HP Screening Form – Fillable
INCOME/ASSET DOCUMENTATION
Verification of Income – Fillable
Self-Declaration of Income – Fillable
Asset Worksheet – Fillable
Income Calculation Worksheet-Fillable
STAFF CERTIFICATION
Staff Certification of Eligibility for SSVF Assistance-Fillable
Staff Re-Certification of Eligibility for SSVF Assistance-Fillable
Domestic Violence Certification Form-Fillable
CASE MANAGEMENT FORMS
Housing Habitability Standards Inspection Checklist-Fillable
Creating a Reasonable Housing Plan-Fillable
Referral Tracking Form-Fillable
Emergency Housing Assistance Verification-For Households with Dependents-Fillable
Emergency Housing Assistance Verification-For Single Veterans-Fillable
General Housing Stability Assistance Expense Tracker Form-Fillable
Rent Reasonableness Checklist
VA REFERRALS TO SSVF
HUD-VASH SSVF Referral Packet for RRH Only-Fillable
HUD-VASH SSVF Referral Packet – FAQ’s
CHECKLISTS
SSVF Program Exit Checklist-Fillable
SSVF Veterans Bill of Rights
OTHER SAMPLE FORMS
Shared Housing Fact Sheet
Shared Housing Roommate Interest Form
Housing General Conversion Process
Shared Housing General Roommate Matching Form
Shared Housing-Housing Preference Worksheet
Shared Housing Path Roommate Agreement
Shared Housing Rent Analysis Worksheet
Shared Housing Toolkit
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