Agency determining assistance:
Society of St. Vincent de Paul
Rent Assistance Application
Customer Consent Form Language:
I hereby consent to and authorize The Society of St. Vincent de Paul ("Agency") to access any financial information from any related credit, bank, or other lender accounts concerning payment history, delinquencies, outstanding amounts owed, required deposits, usage history and other related information, and to use such information in connection with my application for financial assistance on this date. This consent and authorization shall expire following Agency's review of my information for qualification of financial assistance on this date.
Statement of Truth:
Under penalty of perjury and acknowledgement by my signature below, I swear or affirm that the statements made regarding the persons in my home and the income, resources, property and all other items that pertain to my possible eligibility for benefits are true and correct to the best of my knowledge.
Number of Adults
Note: Applicant must be listed on the lease.
Society of St. Vincent de Paul- Phoenix
As indicated by my signature below, I solemnly swear, under penalty of perjury, that the statements regarding my eligibility for services and benefits, along with my submitted documentation, are true and correct to the best of my knowledge.
TWO OPTIONS FOR SENDING DOCUMENTS
Option 1 - if possible, please use the green "File" buttons shown above when taking photos or the brown "Document" buttons for uploading files. These buttons will attach the required files directly to this Application. Attachments will be automatically included with your Application after clicking the blue "Submit Application" button below.
Number of Children
rental assistance request
CURRENT LEASE AGREEMENT
Must be signed by Landlord and Tenant
Lease must include at least the 1st and last pages
Applicant MUST be listed on the lease
Option 2 - if you are using a cell phone, please take a photo of each required document listed above & email to firstname.lastname@example.org Please indicate your full name if sending each photo separate from this Application. Next, click the "SUBMIT" button to email your completed Application.
Submitting this application does NOT guarantee assistance. If you have listed phone & email information, you WILL be contacted regarding the status of your application.
Incorrect or incomplete applications, or applications with missing documents, CANNOT be processed.
When finished, please click the SUBMIT button below to send your completed Application. Please know there will be a slight delay when submitting your uploaded files. After a brief pause, you'll be taken to another page on our site with additional rental assistance resources.
PROOF OF CRISIS - only ONE of the following is needed, relating to ANY family Member:
Termination letter from Employer
Application for benefits
Employer letter of reduced work hours
Unemployment letter/SSI benefits discontinued
COVID-19 related treatment costs or medical bill
COVID-19 related FMLA paperwork
Receipts of any unexpected expenses
Child Care costs related to COVID-19
IDENTIFICATION (one of the following is needed):
INSTRUCTIONS: Please be sure to submit COMPLETED APPLICATION and DOCUMENTS. Our Office will contact you only if copies of ALL DOCUMENTS are submitted. Due to high volumes of applications, we are not able to accept calls regarding application status.
PLEASE PROVIDE SUPPORTING FILES FOR IDENTIFICATION, LEASE, AND CRISIS: