Eligibility & Client Documents
Click on the underlined words to download the related document.
Homelessness Documentation Form - Verification of time homeless not tracked in HMIS.
A person’s self certification of up to 3 months
Third-party verification of any amount of time homeless within the last 36 months either:
outside of Westchester County by any organization/person acting as a witness
inside of Westchester County by organizations/persons who do not utilize HMIS acting as a witness
Disability Verification Form - Verification of: “The diagnosis of a disabling condition by a provider licensed to diagnose and/or treat the condition; and that the disability is expected to be long-continuing and of indefinite duration; and substantially impedes their ability to live independently; and the disability could be improved by the provision of more suitable housing conditions.”
Lieu of completing this form, the following documents are acceptable verification of disability:
Social Security Award Letter from the Social Security Administration stating that the client is receiving benefits due to a specified disability
Single Point of Access (SPOA) Application including a psychiatric assessment including a diagnosis and verifying that the client has a disability.
Single Homeless Assessment Center (SHAC) Assessment can be used when it contains the same HUD approved language quoted above
U.S. Department of Veteran Affairs disability verification documents
Client Rent Calculation Form - This tool is intended to help Continuum of Care (CoC) Program recipients that receive CoC Program Leasing or Rental Assistance funding determine whether or not a prospective unit's rent meets Fair Market Rent (FMR) and Rent Reasonableness standards.
2020 Utility Allowance - The following table is the current* Utility Allowance Schedule used to calculate tenants’ utility costs. Total the tenant paid utilities to determine the total utility allowance for that unit size.