City of St. Louis Impacted Tenants Fund Application

City of St. Louis Impacted Tenants Fund Application
The Impacted Tenants Fund project assists eligible City of St. Louis renters who have been forced to relocate from their residences due to building condemnation or to the May 16th tornado.

Before completing this application, please verify that the impacted dwelling is in the City of St. Louis.

This application can be completed and submitted online below, or you may download a PDF version here. Completed paper applications can be delivered to Employment Connection's offices Monday through Friday from 8am to 4:30pm. Our address is:

Employment Connection
2838 Market Street
St. Louis, MO 63103

Please be sure to bring your application and all required documentation (lease agreement, valid ID, and proof of residency).

Applications will be collected and reviewed on a first-come, first-served basis.

Once your application and documents are turned in, Employment Connection will work with the St. Louis City Building Division to confirm information, and Employment Connection will reach out to you to issue payment.

For questions regarding this application, please call Andrea Lewis, Employment Connection's Manager of Housing Services, at (314) 333-5627 or email impactedtenants@employmentstl.org.

For other questions regarding the Impacted Tenants Fund, please contact the City of St. Louis Department of Human Services at human-services@stlouis-mo.gov or (314) 612-5900.
Applicant Information

The applicant’s name must appear on the lease as the lease holder of the condemned/damaged unit.
Name*

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Qualifying Event

Requests for aid must be tied to a qualifying event that can be confirmed through official city records.
I am applying for aid due to:*

Building or unit condemnation (on or after 1/1/2025)Natural disaster (on or after 5/16/2025)
Event
Date of Event

MonthDayYear
Date of Application
Date Application Submitted*

MonthDayYear
Impacted Address

Requests for aid must be for qualifying events on addresses located within St. Louis city limits. This address must appear as written on the lease.
Address on Lease*

Street Address

Apartment/Unit Number

CityState

Zip Code
Number of Bedrooms in Unit*
Lease Term Starting Date

MonthDayYear
Lease Term Ending Date

MonthDayYear
Attestation of Non-Occupancy

The impacted address must be uninhabitable in order to qualify for aid.
Occupancy Status*

I no longer occupy the apartment or house.I currently reside in the unit, but it has been deemed uninhabitable.
Landlord/Property Manager Information

Please provide as much detail as possible to support your request.
Landlord/Property Manager Name

First NameLast Name
Landlord/Property Manager Email Address
example@example.com
Landlord/Property Manager Phone Number
Please enter a valid phone number.
Landlord/Property Manager Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
Property Owner Information (if different from Landlord/Property Manager)

Please provide as much detail as possible to support your request.
Property Owner Name

First NameLast Name
Property Owner Email Address
example@example.com
Property Owner Phone Number
Please enter a valid phone number.
Property Owner Mailing Address

Street Address

Street Address Line 2

CityState

Zip Code
Income and Household Information (required information)
Are you (the lease holder) currently employed?*

YesNo
Household/Family Annual Income
Household/Family Monthly Income
What are the sources of income for the household/family? (Please select all that apply)

Wages from EmploymentSocial SecurityPensionSSITANFChild SupportOther
Total Number of People in Your Family/Household*
Number of Household Members above the age of 18*
What are the ages of the Household Members above the age of 18?*
Number of Household Members under the age of 18*
Ethnicity

Hispanic or LatinoNot Hispanic or Latino
Race (Please select all that apply)

American Indian or Alaska NativeAsianBlack or African AmericanMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhiteOther
Voluntary Information for Reporting Purposes

This is information we collect to evaluate the impact of the program. You are not required to share this information in order to be eligible for the program.
Have you found another place to live?

Yes, I have signed or am preparing to sign a new lease for permanent housing.No, I am looking for housing.
Is your new residence in the City of St. Louis?

YesNoNot applicable
Submission of Documents
I understand that pursuant to applicable law, eligible tenants receive financial assistance through the Impacted Tenants' Fund on a first-come-first-serve-basis, subject to funding availability. The City of St. Louis, in administering the Impacted Tenants' fund, does not discriminate against any individual or group on the basis of race, color, ethnicity, national origin, religion, age, gender, gender identity or expression, sexual orientation, marital status, disability or any other characteristic protected by applicable laws and regulations.

To be eligible, applicant must be able to provide both of the following documents:
- Valid, signed lease agreement for the impacted unit that was in effect during the qualifying event period. The lease must cover the qualifying event date to verify occupancy at the time of impact.
- Valid Photo ID, Passport, Driver’s License, or other Municipal/State Identification
In addition, applicant must provide one of the following documents with the name of the applicant and the address of the impacted unit:
- Utility bill
- Official Government-Issued Mail (Unemployment letter, social security letter, food/cash assistance award letter, etc.) dated within the last 90 days
- Voter Registration Card
- Current Bank Statement
Document Upload: Valid, Signed Lease Agreement*

Cancelof
Document Upload: Valid Photo ID, Driver's License, Passport, or other Municipal/State Identification*

Cancelof
Document Upload: Utility Bill, Official Government-Issued Mail, Voter Registration Card, or Bank Statement*

Cancelof
By signing below, I understand that providing false, misleading, or intentionally incomplete information on this form constitutes fraud and I may be subject to civil or criminal penalties under 18 U.S.C. 287, 1001, and 31 U.S.C. 3729, as well as Missouri state law, including but not limited to RSMo §§ 575.040 and 575.060.
Applicant's Name*
Applicant's Signature

Clear
Today's Date*

MonthDayYear
Should be Empty:

City of St. Louis Impacted Tenants Fund Application

Applicant Information

Qualifying Event

Date of Application

Impacted Address

Attestation of Non-Occupancy

Landlord/Property Manager Information

Property Owner Information (if different from Landlord/Property Manager)

Income and Household Information (required information)

Voluntary Information for Reporting Purposes

Submission of Documents