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Forms & Manuals

Forms and manuals are available below for local agencies operating the housing and homeless service programs.

 Assessment Tool (DHS Multiple Languages)

 Assessment Tool Initial Screening

 COVID-19 Impacts - Self Certification

 Data Collection Requirements by Program and Project Type​​

 Disability - Third Party Verification

 Emergency Shelter-Low Barrier Self Assessment & Action Plan

 ERA Rental Subsidy Agreement

 ERA & HSP Habitability Standards Checklist/Certification​​

 ESG At-Risk Homeless Status Defining

 ESG At-Risk Homeless Status Documenting

 ESG At-Risk Homeless Status Staff Certification Checklist

 ESG Continuum of Care Approval

 ESG Eligible Cost Reference Guide

 ESG Habitability Standards and Certification

 ESG Homeless Status Documenting Chronic Homelessness

 ESG Homeless Status Documenting Homelessness Prevention

 ESG Homeless Status Documenting Rapid ReHousing

 ESG Homeless Status Eligibility by Component

 ESG Homeless Status Flowchart of Chronic Homelessness

 ESG Local Government Approval

 ESG Quarterly Match Report Template​​

 ESG Standards and Eligibile Activities

 Homeless Status - Simplified Documentation

 Homeless Status Defining

 Homeless Status Documenting

 Homeless Status Self-Certification

 Homeless Status Self-Certification Checklist

 Housing Stability Self Sufficiency Plan

 HSP Barriers Assessment

 HSP Barriers Assessment Plan

 HSP Citizenship Self-Certification

 HSP Collaboration Plan Template

 HSP Identity-Age-Residency Documenting

 ​HSP Federal Poverty Guidelines

 HSP Release of Information (DHS Multiple Languages)

HSP Referral Form

 HSP Tracking Spreadsheet

 HTBA Applicant Notification

 HTBA Coupon

 HTBA Student Status Third Party Verification

 Income Documenting

 Income Documenting Lack of Housing Options and Resources

 Income Eligibility Calculation Worksheet

 Income Inclusions and Exclusions

 Income Self-Certification of Zero Income

 Income Self Employment Certification

 Income Staff Verification Checklist

 Income Third Party Verification of Child Care Expenses

 Income Third Party Verification of Child Support

 Income Third Party Verification of Informal Support

 Income Third Party Verification of Public and Job Asst. Training

 Income Third Party Verification of Social Security

 Income Third Party Verification of Wages

 Lead Based Paint Disclosure

 Notice of Equal Access

 Participant File Checklist

 Policy Templates (2023-2025)

 Preferred Order of Documentation Checklist

 Privacy Notification

 Referral Tracking

 Rent Reasonableness and FMR Certification

 Self Sufficiency Scoring Matrix

 Should it be a Subrecipient or Contractor Checklist

 VAWA Forms


Contact:

Program Analyst
Housing & Homeless Services Section