Anti-Displacement Application Form

Name*

First NameLast Name

Date of Birth*

Date

Gender*

Ethnicity*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Highest Level Of Education Completed*

Active Military*

Veteran *

Are you currently enrolled in any City of Austin programs*

What City Of Austin program are you currently enrolled in?*

Do you have legal decision-making authority regarding the status of the home in question?*

if no, please provide explanation why and list the name(s), contact number(s) of individual(s) are able to make legal decision.

Please briefly explain your current housing situation and why you believe you are at risk of displacement due to the Project Connect line*

Please provide a picture of your driver's license, or identification card to verify your identity. *

Please provide the following documents for income verification, such as paystub, W-2, or any other verifiable income document. If you do not have income, please provide a brief notarized letter stating so*

Please provide the following documents for verification of residency ownership (ie. current lease, mortgage)*

Legal Documentation (if applicable)

Total Household Members (including yourself)*

Household Income (Gross Annual)*

Number of Dependents (may differ than household size)*

Estate Planning (i.e Wills, Trust, Medical Power of Attorney)Workshops (i.e Educational Workshops, Financial Workshops)Housing Support ( Repair, Land Information)Deeds and Survey Request

Open Title Request Form

I, the undersigned, hereby authorize Life Anew Restorative Justice and its designated legal and housing partners to begin the process of reviewing, researching, and supporting the documentation related to the ownership status of my property located at the address on record.

I understand that this service is being offered in support of efforts to reduce displacement, preserve generational wealth, and provide estate planning support for qualified homeowners.

This disclaimer is a formal request to ensure the clear deed ownership and title of my property, and to support estate planning or related services available through Life Anew and its legal partners.

I understand that this process may include obtaining a title search, affidavits of heirship, surveys, or other legal documentation as needed. I also acknowledge that no legal transfer, sale, or relinquishment of property is being requested or initiated by your authorization.

I affirm that I am either the current homeowner or have a legal interest in the property and am seeking clarification or resolution of the title status for the purposes described above.

If applicable or available, please enclose a copy of the prior owner’s Title Policy and prior survey of the property.

By selecting the Deeds and Survey Request, your signature at the end of this application will authorize Life Anew Restorative Justice to obtain documents requested at no cost to you.

Are you the Applicant or signing on behalf of the applicant?*

By signing you hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that the Anti-Displacement Program may request additional documentation for verification prior to being allowed into the program.*

Anti-Displacement Application Form

Household Information