721 SE 3rd, Suite D Pendleton, OR 97801 541-276-1926 | 800-752-1139
Serving Gilliam, Hood River, Morrow, Sherman, Umatilla, Wasco, and Wheeler counties
Applicant’s will need the following documentation to be considered eligible for CAPECO Eviction Prevention Program (CEPP):
Applications are processed on a priority basis.
**Please note that the Landlord Statement can be automatically emailed to your landlord or property manager during the online application process.
This application is for Oregon residents living in Gilliam, Morrow, Umatilla or Wheeler counties only. If you live outside these counties please contact an agency in your county of residnece - See the Directory of Oregon Community Action Agencies below.
Baker County - Community Connection of NE Oregon - ccno.org, 541-963-3186Benton County - Community Services Consortium - communityservices.us, 541-928-6335Clackamas County - Clackamas County Social Services - clackamas.us/h3s, 503-650-5697Clatsop County - Community Action Team Inc - cat-team.org, 503-397-3511Columbia County - Community Action Team Inc - cat-team.org, 503-397-3511Coos County - Oregon Coast Community Action - orcca.us, 541-435-7080Crook County - Neighbor Impact - neighborimpact.org, 541-548-2380Curry County - Oregon Coast Community Action - orcca.us, 541-435-7080Deschutes County - Neighbor Impact - neighborimpact.org, 541-548-2380Douglas County - United Community Action Network - ucancap.org, 541-956-4050Grant County - Community Connection of NE Oregon - ccno.org, 541-963-3186Harney County - Community in Action - communityinaction.info, 541-889-9555Hood River County - Mid-Columbia Community Action Council - mccac.com, 541-298-5131Jackson County - ACCESS - accesshelps.org, 541-779-6691Jefferson County - Neighbor Impact - neighborimpact.org, 541-548-2380Josephine County - United Community Action Network - ucancap.org, 541-956-4050Klamath County - Klamath/Lake Community Action Services - klcas.org, 541-882-3500Lake County - Klamath/Lake Community Action Services - klcas.org, 541-882-3500Lane County - Lane County Human Services Commission - lanecounty.org, 541-682-3798Linn County - Community Services Consortium - communityservices.us, 541-928-6335Lincoln County - Community Services Consortium - communityservices.us, 541-928-6335Malheur County - Community in Action - communityinaction.info, 541-889-9555Marion County - Mid-Willamette Valley Community Action Agency - mwvcaa.org, 503-585-6232Multnomah County - Human Services, Youth & Family Services - multco.us, 503-988-3691Polk County - Mid-Willamette Valley Community Action Agency -mwvcaa.org, 503-585-6232Sherman County - Mid-Columbia Community Action Council - mccac.com, 541-298-5131Tillamook County - Community Action Team Inc - cat-team.org, 503-397-3511Union County - Community Connection of NE Oregon - ccno.org, 541-963-3186Wallowa County - Community Connection of NE Oregon - ccno.org, 541-963-3186Wasco County - Mid-Columbia Community Action Council - mccac.com, 541-298-5131Washington County - Community Action - caowash.org, 503-693-3221Yamhill County - Yamhill Community Action Partnership - yamhillcap.org, 503-472-0457
[Only applicants with court dates and notices to appear are eligible for assistance at this time.]
If “Yes” there may be a possibility that you will be ineligible for assistance.
A 'Landlord Statement' is required.
By entering your landlord's email above, the Landlord Statement will be automatically sent to them.
If your landlord does not have email, you will need to have them sign a physical copy of the Landlord Statement, which can be found on the CAPECO website.
Please tell us who is in your household:
Additionally, in order for CAPECO to determine eligibility for this application you will need to provide Social Security Numbers (SSN) for every household member AND a state or federal issued photo identification (ID) for every household member who is 18 years old or older.
To provide SSNs and photo IDs here, read the entire terms and conditions and select the first box, then complete a row for each household member and upload copies of IDs.
List ALL household members here:
If you are not filling in all required fields for the questions on this form you will receive an error message.
To be able to move through this form you will need to fill in all required fields.
You may need to use the scroll bars to reveal all required fields above.
What is your race/ethnicity?
*Why do we ask this? HUD asks us to collect this information to make sure that laws that protect people from being discriminated against are followed. If you are uncomfortable sharing this information, please check “prefer not to answer”.
Please tell us about your household’s income:
Please list all gross income (amount before taxes/deductions) for all members of your household.
‘Kind of income’ may include wages, social security benefits, TANF, child support, etc.
By signing this form, I hereby authorize CAPECO to provide information to Oregon Housing and Community Services (OHCS) including the Homeless Management Information System (Service Point). I further authorize OHCS and its agents to access any records in order to verify information given. I understand this release is good for three years from the date the application is signed.
I consent to any legally authorized investigation for confirmation of any information that I provide. I consent to have my Landlord share tenant records and other information with OHCS or its agents.
If I receive assistance to which I am not entitled as a result of withholding information or knowingly giving fraudulent information, I must repay that assistance and may be found guilty of fraud and fined up to $10,000 put in prison or both. I understand that no person may be denied assistance on the basis of race, color, sex, age, handicap, religion, national origin or political belief.
I acknowledge that I have received notice outlining my rights to request a fair hearing if my application is unjustly denied. I further understand that I must request a hearing within thirty (30) days of the completed date of the application or date of denial.
I certify that the information above and any other information I have provided in applying for housing assistance is true, accurate and complete.
If you disagree with the denial or limits of eligibility or of the termination or modification of benefits or other assistance awarded by CAPECO, you can request an informal review within thirty (30) days of the decision, by contacting CAPECO. A request for an informal review shall be personally presented, either orally or in writing so the grievance may be discussed informally and settled without a hearing.
If you cannot settle the issue this way or you are still not satisfied you may request a hearing, in writing, to occur within thirty (30) days after the informal review. The Complainant will be provided with a copy of CAPECO’s Formal Hearing Process. A Hearing Officer will arrange a date, time and place convenient to both you and CAPECO. After your request is received, a fair hearing will be scheduled within fourteen (14) days. In preparing for the hearing you have the right to examine any documents, including records and regulations that are directly relevant to the hearing. You have the right to be represented by counsel or other person chosen as your representative. You have the right to a private hearing unless you request a public hearing. You have the right to present evidence and arguments in support of your grievance and to controvert evidence. You also have the right to cross-examine all witnesses. The Hearings Officer must render a decision within ten (10) days of the hearing. The decision of the Hearings Officer will be final.
When a case manager reaches out to you, you will have 48 business hours to return any documentation that is missing from your application. If you do not return your documents in the allotted time frame you will be denied, at that time you will need to reapply if you continue to need assistance.
Applications are processed by priority.
OFFICE USE ONLY - DO NOT WRITE IN SHADED AREA
Completed Application Received – Date Stamp / Time: ____________
⬜ Staff Member ____________________
⬜ Total amount approved $________________
⬜ Date of Approval __________________
⬜ Reviewed by __________________
⬜ Date submitted to Finance _________
Check Number _________
Date Paid _________