Housing Inventory Working Request

HMIS Housing Inventory Request
Rental Subsidies and Vouchers

Does your program operate with rental subsidies or vouchers? Please complete if applicable to your program.
Which update do you need to make for your program inventory?

New InventoryChanging Inventory
What is your program/project's Annual budget for Rental Subsidies or Housing Vouchers?
Example: $120,000
Which household types do you serve?

Households without childrenHouseholds with at least 1 adult and 1 minor childHouseholds with only children
Please complete the sections below based on your selection above of household types you serve:

Households without children
What percentage of Households without children does your project serve?
Example: 69% out of 100%
If your project serves Adult Only Households, what is the average fair market rate for a unit if your project was subsidizing the FULL rent?
Example: $950 for studio apartment

Households with at least 1 adult and 1 minor child
What percentage of Family Households (at least 1 Adult and 1 Minor child) does your project serve?
Example: 30% out of 100%
If your project serves Family Households, what is the average fair market rate for a unit if your project was subsidizing the FULL rent for the average Family Household?
Example: $1,400 for 2 bedroom apartment
If your project serves Family Households, what is the average Family Household size?
Example: 3, 1 adult with 2 children

Households with only children
What percentage of Households with only children does your project serve?
Example: 1% out of 100%
If your project serves Households with only children, what is the average fair market rate for a unit if your project was subsidizing the FULL rent?
Example: $600 for room for rent

HMIS Housing Inventory Request
HMIS Bed Inventory
Households without children

Households composed exclusively of persons who are 18 years of age or older.
Does your project serve Households without children?*

YesNo

HMIS Housing Inventory Request
Households without children

Households composed exclusively of persons who are 18 years of age or older.
Which update do you need to make for your program inventory?

New InventoryChanging Inventory
What is the Inventory Start Date or Changing Date?

MonthDayYear
Date
Inventory Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please review the dedicated bed definitions below to provide the correct bed inventory information:
- Youth-Veterans Beds — The number of beds that are dedicated to house youth (persons up to age 24) Veterans experiencing homelessness and their household members.
- Any other Veteran Beds — The number of beds that are dedicated to house Veterans who are not youth and not experiencing chronic homelessness and their household members.
- Any Other Youth Beds — The number of beds that are dedicated to house youth (persons up to age 24) experiencing homelessness who are not Veterans and are not experiencing chronic homelessness, and their household members.
- Any Chronically Homeless Beds — Beds dedicated to non-youth, non-Veteran persons experiencing homelessness.
- Non-Dedicated Beds — All other (non-dedicated) beds not already accounted for in dedicated beds.
Please provide dedicated (if applicable) & non-dedicated beds for Households without children:
Total Beds
This is calculated from your numbers provided above

Emergency Shelters Only
What is the Bed Type?

Facility-based: Beds (including cots or mats) are located in a residential homeless assistance facility dedicated for use by persons who are homeless.Voucher: Beds are located in a hotel or motel and made available by the homeless assistance project through vouchers or other forms of payment.Other: Beds are located in a campground, church or other facility not dedicated for the use by persons who are homeless.
What is the Bed availability?

Year-roundSeasonal: Beds available on a planned basis with a set start and end date during periods of high demand.Overflow: Beds available during high demand that exceeds available inventory.
If Bed Availability is Seasonal, please enter the ending date.

MonthDayYear
Date

HMIS Housing Inventory Request
HMIS Unit and Bed Inventory
Does your project serve Households with at least 1 adult and 1 minor child?*

YesNo

HMIS Housing Inventory Request
Unit Inventory

Households with at least 1 adult and 1 minor child
Which update do you need to make for your program inventory?

New InventoryChanging Inventory
What is the Inventory Start Date or Changing Date?

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is the total number of units for Households with at least 1 adult and 1 minor child?
Definition for units is the number households your project can provide housing for on a given night.
Bed Inventory

Households with at least 1 adult and 1 minor child
Please review the dedicated bed definitions below to provide the correct bed inventory information:
- Youth-Veterans Beds — The number of beds that are dedicated to house youth (persons up to age 24) Veterans experiencing homelessness and their household members.
- Any other Veteran Beds — The number of beds that are dedicated to house Veterans who are not youth and not experiencing chronic homelessness and their household members.
- Any Other Youth Beds — The number of beds that are dedicated to house youth (persons up to age 24) experiencing homelessness who are not Veterans and are not experiencing chronic homelessness, and their household members.
- Any Chronically Homeless Beds — Beds dedicated to non-youth, non-Veteran persons experiencing homelessness.
- Non-Dedicated Beds — All other (non-dedicated) beds not already accounted for in dedicated beds.
Please provide dedicated (if applicable) & non-dedicated beds for Households with at least 1 adult and 1 minor child:
Total Beds
This is calculated from your numbers provided above

Emergency Shelters Only
What is the Bed Type?

Facility-based: Beds (including cots or mats) are located in a residential homeless assistance facility dedicated for use by persons who are homeless.Voucher: Beds are located in a hotel or motel and made available by the homeless assistance project through vouchers or other forms of payment.Other: Beds are located in a campground, church or other facility not dedicated for the use by persons who are homeless.
What is the Bed availability?

Year-roundSeasonal: Beds available on a planned basis with a set start and end date during periods of high demand.Overflow: Beds available during high demand that exceeds available inventory.
If Bed Availability is Seasonal, please enter the ending date.

MonthDayYear
Date

HMIS Housing Inventory Request
HMIS Bed Inventory
Households with Children Only
Does your project serve Households with children only?*

YesNo

HMIS Housing Inventory Request
HMIS Bed Inventory
Households with Children Only
Which update do you need to make for your program inventory?

New InventoryChanging Inventory
What is the Inventory Start Date or Changing Date?

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please review the dedicated bed definitions below to provide the correct bed inventory information:
- Youth-Veterans Beds — The number of beds that are dedicated to house youth (persons up to age 24) Veterans experiencing homelessness and their household members.
- Any Other Youth Beds — The number of beds that are dedicated to house youth (persons up to age 24) experiencing homelessness who are not Veterans and are not experiencing chronic homelessness, and their household members.
- Any Chronically Homeless Youth Beds — The number of beds that are dedicated to house youth (persons up to age 24) experiencing chronic homelessness and their household members. This bed inventory information is only required for PSH & PH project types.
- Non-Dedicated Beds — All other (non-dedicated) beds not already accounted for in dedicated beds.
Please provide dedicated (if applicable) & non-dedicated beds for Households with children only:
Total Beds
This is calculated from your numbers provided above

Emergency Shelters Only
What is the Bed Type?

Facility-based: Beds (including cots or mats) are located in a residential homeless assistance facility dedicated for use by persons who are homeless.Voucher: Beds are located in a hotel or motel and made available by the homeless assistance project through vouchers or other forms of payment.Other: Beds are located in a campground, church or other facility not dedicated for the use by persons who are homeless.
What is the Bed availability?

Year-roundSeasonal: Beds available on a planned basis with a set start and end date during periods of high demand.Overflow: Beds available during high demand that exceeds available inventory.
If Bed Availability is Seasonal, please enter the ending date.

MonthDayYear
Date

HMIS Housing Inventory Request

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HMIS Housing Inventory Request

Welcome to the HMIS Housing Inventory Request!

HMIS Housing Inventory Request

Rental Subsidies and Vouchers

HMIS Housing Inventory Request

HMIS Bed Inventory

Households without children

HMIS Housing Inventory Request

Households without children

HMIS Housing Inventory Request

HMIS Unit and Bed Inventory

HMIS Housing Inventory Request

Unit Inventory

Bed Inventory

HMIS Housing Inventory Request

HMIS Bed Inventory

Households with Children Only

HMIS Housing Inventory Request

HMIS Bed Inventory

Households with Children Only

HMIS Housing Inventory Request