• Image field 1
  • Image field 738

  • Bring It Home Rental Assistance Participant Application

    Privacy Notice. The household and Minnesota Housing Finance Agency (MHFA) must comply with the Minnesota Governmnet Data Practices Act, Minn. Stat. Ch. 13, as it applies to all data provided by MHFA under this agreement, and as it applies to all data created, collected, received, stored, used, maintained, or disseminated by the household under this agreement. The civil remedies of Minn. Stat. 13.08 apply to the release of the data referred to in this clause by either the household instructions concering the release of the data to the requesting part before the data is released. The household's response to the request shall comply with applicable law.

    The Bring It Home Rental Assistance Program, also referred to as "Bring It Home", is a new program created to provide rental assistance for low-income families across Minnesota.

    To be eligible for this program, applicants must:

    • Be a Minnesota resident
    • Have an annual income of up to 50% of the area median income, adjust for family size
    • Be a household that is paying more than 30% of the household's income on rent or is unhoused
    • Be a household that is not currently receiving federal tenant-based or project-based assistance under Section 8 of the United States Housing Act of 1937, as amended

    Priority for rental assistance must be given to:

    • Households with children 18 years of age and under
    • Household annual incomes of up to 30% of area median income
    • Other priority populations identified by the Program Administrator

    Instructions

    When filling out this application, use legal names for all household members. All household members 18 years of age and above must this this application certifiying that the information is true and accurate to the best of their knowledge.

     

    November 2025 [last updated]

    1

     

  • Date
     / /

  • Head of Household (HOH) Information

  • Do you have a phone number we can reach you at?*
  • Format: (000) 000-0000.
  • Do you need an interpreter?*
  • Is anyone in your household pregnant?*
  • Do you currently receive rent assistance?*
  • Are you in a current rental agreement with a lease?*
  • Current Living Situation*

  • All Household Members (including head of household)

  • Disability: Y=Yes N=No D=Decline to Answer
    Citizenship: E=Eligible Citizen EN=Eligible Non-Citizen I=Ineligible Citizen P=Pending Verification
    Gender: M=Male F=Female O=Other
    Race: A=Asian B=Black/African American I=American Indian/Alaskan Native W=White P=Native Hawaiian/Pacific Islander
    Ethnicity: Hispanic? Y=Yes N=N

  • Head of Household

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #2

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #3

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #4

  • Birth Date*
     / /

  • Diability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #5

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #6

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M     = Male
    F = Female
    O = Other

  • Race Options:
    A     = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #7

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M = Male
    F = Female
    O = Other

  • Race Options:
    A = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y     = Yes
    N = No

  • Member #8

  • Birth Date*
     / /

  • Disability Options:
    Y     = Yes
    N = No

  • Full Time Student Options:
    Y     = Yes
    N = No

  • Gender Options:
    M = Male
    F = Female
    O = Other

  • Race Options:
    A = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y = Yes
    N = No

  • Member #9

  • Birth Date*
     / /

  • Disability Options:
    Y = Yes
    N = No

  • Full Time Student Options:
    Y = Yes
    N = No

  • Gender Options:
    M = Male
    F = Female
    O = Other

  • Race Options:
    A = Asian
    B = Black/African American
    I = American Indian/Alaskan Native
    W = White
    P = Native Hawaiian/Pacific Islander

  • Ethnicity Options:
    Y = Yes
    N = No

  • November 2025 [last updated]

    2

  • Household (HH) Income

  • List the monthly amount of gross income that your household receives. Gross income is the total income received before subtracting taxes or other deductions. All income listed will require additional proof to be provided.

  • Does anyone in the household receive income from Employment?*

  • Employment #1

  • Employment #2

  • Employment #3

  • Does anyone in the household receive Social Security (SS)?*

  • Social Security (SS) #1

  • Social Security (SS) #2

  • Social Security (SS) #3

  • Does anyone in the household receive SSDI (Social Security Disability Insurance)?*

  • SSDI (Social Security Disability Insurance) #1

  • SSDI (Social Security Disability Insurance) #2

  • SSDI (Social Security Disability Insurance) #3

  • Does anyone in the household receive income from Annuities?*
  • Does anyone in the household receive income from Insurance Policies - Life Insurance, Insurance Settlement, etc.?*
  • Does anyone in the household receive income from Retirement Funds?*
  • Does anyone in the household receive income from a Pension - PERA, Railroad, etc.?*
  • Does anyone in the household receive income from Unemployment?*
  • Does anyone in the household receive income from Worker's Compensation?*
  • Does anyone in the household receive income from Severance Pay?*
  • Does anyone in the household receive Public Assistance - MFIP/GA/MSA/TANF/HG?*
  • Does anyone in the household receive income from Alimony (Spousal Maintenance)?*
  • Does anyone in the household receive Child Support?*
  • Does anyone in the household receive income from Regular Contributions?*
  • Do you have any other incomes to add?*

  • Other Income #1

  • Other Income #2

  • Other Income #3

  • Other Income #4

  • November 2025 [last updated]

    3

  • Household Assets (if applicable)

  • List all current amounts of assets in your household. All listed assets may require additional proof to be provided.
  • Does anyone in the household have a savings account?*

  • Savings Account #1

  • Savings Account #2

  • Savings Account #3

  • Does anyone in the household have a checking account?*

  • Checking Account #1

  • Checking Account #2

  • Checking Account #3

  • Does anyone have cash on hand?*
  • Does anyone have a Revocable Trust?*
  • Does anyone have Rental Property Equity?*
  • Does anyone have Stocks / Bonds / Mutual Funds / Certificate of Deposits?*
  • Does anyone have a Retirement / 401K?*
  • Does anyone have Annuities?*
  • Does anyone have a Pension?*
  • Does anyone have Life Insurance Policies?*
  • Does anyone have Personal Property?*
  • Do you have any other assets to add?*

  • Asset #1

  • Asset #2

  • Asset #3

  • Household Expense Information (if applicable)

  • Does your household have childcare expenses (daycare, before/after school care) that allows the head of household to work or go to school full-time?*
  • Does your household have out of pocket medical expenses?*

  • November 2025 [last updated]

    4

  • State Priority Population Verification

  • Does you household have children aged 18 years or younger?*
  • Is your household's annual income less than 30% of the Area-Median-Income?*

  • Emergency Contact

  • Do you want to add anyone outside of your household to help with this application process and/or annual recertification? (Before being able to speak with this individual, we will need a release of information)*
  • Format: (000) 000-0000.
  • Do you have a caseworker you would like to add? (Before being able to speak with this individual, we will need a release of information)*
  • Format: (000) 000-0000.

  • Signatures From All Household Members 18 Years of Age and Older

  • By signing this form, you are certifying that, to the best of your knowledge, the provided information is true and accurate.

  • Date:*
     / /
  • Date:*
     / /
  • Date:*
     / /
  • Date:*
     / /
  • Date:*
     / /
  • Date:*
     / /
  • Date:*
     / /

  • November 2025 [last updated]

    5

  • Should be Empty: