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Agency determining assistance:


Society of St. Vincent de Paul- Our Lady of Perpetual Help Conference, Scottsdale, AZ

Rent Assistance Application for people living in Scottsdale, AZ
Zip Code 85251 

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

applicant information

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. 

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.

Thank you!

Number of Children

rental assistance request

Type of Crisis (check all that apply):



required documents

Image File
Image File
Image File


  • 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 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.  Be sure to call us at (480) 945-5268 so we can reply to you promptly.

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):

  • Driver's License or State Issued I.D.

  • ID Card from Health Benefits or Social Services program

  • Social Security Cards

  • Voter Registration Card

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.



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