Austin Tenant Relocation Assistance Program Application

AUSTIN TENANT RELOCATION ASSISTANCE PROGRAM

Application and Intake Form
City of Austin Tenant Relocation
Assistance Program

Supporting Displaced Tenants with Relocation Services

The City of Austin's Tenant Relocation Assistance Program is dedicated to providing essential support to tenants facing displacement through no fault of their own. We understand the challenges associated with relocation and are committed to assisting eligible individuals in their transition.

Application Process:

Individuals must submit a formal application to the City of Austin Tenant Relocation Assistance Program to be considered for assistance. We encourage all eligible tenants to complete the following application.

To ensure your application's accurate and efficient processing, we will require specific supporting documentation. Please review the checklist below and provide the necessary documents as applicable. Failure to submit the required documentation may result in delays or the rejection of your application.

Please include the following supporting documentation with your application:
- Proof of Identity: Valid government-issued I.D.
- Proof of Income: Latest tax return (IRS form 1040 signed and submitted) OR one of the following:
  - Last three months of pay stubs
  - A signed statement from the employer stating wage and frequency of payment on official letterhead
  - Social Security or disability , retirement, TANF, pension or annuity: CURRENT letter of benefits should include benefit amount
- Proof of Primary Residence: A lease AND one of the following displaying current address:
  - Utility bill
  - Bank Account Statement
  - Renters Insurance Policy
  - Voter registration
Please ensure that all supporting documentation is clear, legible, and current. If you have questions about which documents are required or need assistance with gathering the necessary information, please get in touch with us at austintenantrelocation@laveerlogix.com or 512-370-2334.

Note: Failure to provide requested supporting documentation as requested may delay the processing of your application or the inability to consider your application for assistance.

Review Process:

Applications will be thoroughly reviewed on a first-come, first-served basis. The program aims to serve eligible tenants promptly and efficiently. Please note that the availability of funds is subject to allocation based on the demand and eligibility criteria.

Use of Funds:

Funds disbursed by the City of Austin Tenant Relocation Assistance Program will be allocated exclusively for relocation expenses as determined by the program. These expenses may include, but are not limited to, moving costs, temporary housing, and related essentials to facilitate a smooth transition for eligible tenants.

We are dedicated to assisting tenants facing unforeseen displacement and ensuring they have the support they need during this challenging time. The City of Austin Tenant Relocation Assistance Program is committed to maintaining fairness, transparency, and efficiency in its operations.

Submission of this application does not guarantee approval. All applications will be subject to review, and applicants will be notified of the decision according to our selection process.

CURRENT CONTACT INFORMATION
Applicant Name*
Please enter first and last name
Applicant Contact Number*
Alternate Phone Number
E Mail Address*
example@example.com
Co-applicant Name
Please enter first and last name
Co-Applicant Contact Number
Emergency Contact Name*
Please enter first and last name
Emergency Contact Number*
Landlord/Property Management Company*
Landlord/ Property Management Contact Number*
Preferred Contact Method*

Phone CallEmailText Message

HOUSEHOLD

Enter information for all individuals currently residing in household.
Head of Household
Name*

First NameLast Name
Relationship to Head of Household*
Date of Birth*

MonthDayYear
Gender*
Age*
Ethnicity*
Race*
Special Needs 1
Special Needs 2
Household Member #1
Name

First NameLast Name
Relationship to Head of Household
Date of Birth

MonthDayYear
Date
Gender
Age
Ethnicity
Race
Special Needs 1
Special Needs 2
Household Member #2
Name

First NameLast Name
Relationship to Head of Household
Date of Birth

MonthDayYear
Date
Gender
Age
Ethnicity
Race
Special Needs 1
Special Needs 2
Household Member #3
Name

First NameLast Name
Relationship to Head of Household
Date of Birth

MonthDayYear
Date
Gender
Age
Ethnicity
Race
Special Needs 1
Special Needs 2
Household Member #4
Name

First NameLast Name
Relationship [to Head of Household]
Date of Birth

MonthDayYear
Gender
Age
Ethnicity
Race
Veteran
Special Needs 2
Highest Education Level Completed
Special Needs 1
Additional Household Members

I have more than five [5] household members that are relocating.

IMMEDIATE UNMET NEEDS
Do you require any immediate assistance? Select from the following:
Do you require any additional immediate assistance? Select from the following:
Do you have any additional requests for assistance? Select from the following:

DOCUMENT UPLOAD

The program reserves the right to verify documentation provided for the purpose of eligibility screening. The applicant may be required to provide additional documents at the request of the program.
Please provide a Valid Photo I.D. (not expired) for all household members over the age of 18.
- State/ Government Issued I.D.
- Passport
- Driver's License
Please provide Income documentation for all adults Household Members over the age of 18.
- Latest tax return (IRS form 1040 signed and submitted) OR
- Salary/Wage: last 3 months of pay stubs OR signed statement from employer stating wage and frequency of payment on official letterhead
- Benefits: Social Security or disability, retirement, TANF, pension or annuity-CURRENT letter of benefits should include benefit amount.
Proof of Primary Residence. A Primary Residence is defined as a main dwelling you reside in for most of the year. All documentation should be in the applicant or co-applicant’s name and match the current address.

Please provide a copy of your lease AND one of the following:
- Utility bill
- Bank Account Statement
- Renters Insurance Policy
- Voter registration
Head of Household:
- Proof of ID
- Proof of Residence
- Proof of Income
Submit Forms Here for Head of Household*

Cancelof
Household Member 1 [over the age of 18]:
- Proof of ID
- Proof of Income
Submit Documents Here for Household Member 1

Cancelof
Household Member 2 [over the age of 18]:
- Proof of ID
- Proof of Income
Submit Documents Here for Household Member 2

Cancelof
Household Member 3 [over the age of 18]:
- Proof of ID
- Proof of Income
Submit Documents Here for Household Member 3

Cancelof
Household Member 4 [over the age of 18]:
- Proof of ID
- Proof of Income
Submit Documents Here for Household Member 4

Cancelof
Additional Household Members

I have more than five [5] household members over the age of 18 that are relocating.

APPLICANT'S VERIFICATION

Required Certification
I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that any misrepresentation or false information may result in the denial of assistance or repayment of funds provided. I understand that the amount of funding received will be determined
Applicant Name (print)*
Applicant Signature*

Clear
Co Applicant Name (print)
Co Applicant Signature

Clear
Should be Empty:

AUSTIN TENANT RELOCATION ASSISTANCE PROGRAM

CURRENT CONTACT INFORMATION

ELIGIBILITY: INCOME

ELIGIBILITY: HOUSING

HOUSING ASSESSMENT

HOUSEHOLD

Head of Household

Household Member #1

Household Member #2

Household Member #3

Household Member #4

IMMEDIATE UNMET NEEDS

DOCUMENT UPLOAD

APPLICANT'S VERIFICATION