2026-2027 Tenants Assistance Program (TAP)
Delinquent Rent and Security Deposit assistance funded by the IDHS HP program in order to prevent homelessness in Lake County, Illinois. TAP does not assist with mortgages or utility bills.
TAP is funded by the Illinois Department of Human Services Homeless Prevention grant, who has established the following participation requirements and program rules.
Applicants who do not meet ALL program rules and requirements cannot be funded.
Please acknowledge ALL program rules and requirements.
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Applicants will be denied if they recived funds from ANY IDHS Homeless Prevention Program in the past 24 months.
Applicants must be a tenant with a rental unit located in Lake County, Illinois.
Applicants must be experiencing a documented, temporary, economic crisis that is beyond their control.
Applicants must be facing homelessness or the threat of homelessness.
Applicants must be able to cover the financial cost of housing, utilities, and transportation after assistance has ended.
This program requires Landlords or Property Managers to agree to receive funding - direct to tenant assistance is not allowed per IDHS HP program rules.
If applying for security deposit, the household must provide proof that they have already been approved for this rental unit.
This program has limited funds. Assistance is on a first come, first serve basis and funds are subject to availability.
Applicants will not be reviewed or approved for funding until ALL supportive documents are received from the applicant and the landlord.
Please acknowledge that you MUST provide ALL of the following:
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Names and information for all persons in the household.
Valid contact information (email, phone number) for your head of household.
Valid contact information (email, phone number) for your Landlord or Property Manager.
Valid, current, signed lease.
Ledger of rents owed (for those applying for delinquent rent).
Proof of Identification for the Head of Household
Proof of Household income from all sources.
Proof of residency.
Proof of temporary, economic crisis.
Signature
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Today's Date
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Month
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Day
Year
Date
Post-Submission Upload (optional)
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Head of Household Information
Name for Head of Household
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First Name
Last Name
How many persons are in your household?
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Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Head of Household Disability Status
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Disabled
Not Disabled
Head of Household Status
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Single Male, NO children
Single Female, NO children
Couple No Child
Couple with Child/Children
Single Male with Child/Children
Single Female with Child/Children
Head of Household Date of Birth
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Month
-
Day
Year
Date
Head of Household Social Security Number
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Head of Household Race
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American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Other Pacific Islander
White
American Indian / Alaskan Native & White
Asian & White
Black / African American & White
American Indian / Alaskan Native & Black / African American
Other
Head of Household Ethnicity
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Hispanic or Latino
Non-Hispanic and Non-Latino
Head of Household Highest Level of Education
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Above Masters Degree
Masters Degree
Bachelor's Degree
Junior College
HS Diploma or Equivalent
Below HS Diploma
Elementary
Other
Head of Household Veteran Status
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Active Military
Veteran
NOT a Veteran OR Active Military
Head of Household Primary Language
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Current Address (NOT the address of the future rental)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Additional Persons in Household
Person #2
Name of Person #2
First Name
Last Name
Is Person #2 Disabled?
Yes
NO
Person #2 Gender
Female
Male
Person #2 Date of Birth
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Month
-
Day
Year
Date
Person #2 Social Security Number (enter 000-00-0000 if unknown)
Person #2 Race
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Other Pacific Islander
White
American Indian / Alaskan Native & White
Asian & White
Black / African American & White
American Indian / Alaskan Native & Black / African American
Other
Person #2 Ethnicity
Hispanic or Latino
Non-Hispanic and Non-Latino
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Additional Persons in Household
Person #3
Name of Person #3
First Name
Last Name
Is Person #3 Disabled?
Yes
No
Person #3 Gender
Female
Male
Person #3 Date of Birth
-
Month
-
Day
Year
Date
Person #3 Social Security Number (enter 000-00-0000 if unknown)
Person #3 Race
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Other Pacific Islander
White
American Indian / Alaskan Native & White
Asian & White
Black / African American & White
American Indian / Alaskan Native & Black / African American
Other
Person #3 Ethnicity
Hispanic or Latino
Non-Hispanic and Non-Latino
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Additional Persons in Household
Person #4
Name of Person #4
First Name
Last Name
Is Person #4 Disabled?
Yes
No
Person #4 Gender
Female
Male
Person #4 Date of Birth
-
Month
-
Day
Year
Date
Person #4 Social Security Number (enter 000-00-0000 if unknown)
Person #4 Race
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Other Pacific Islander
White
American Indian / Alaskan Native & White
Asian & White
Black / African American & White
American Indian / Alaskan Native & Black / African American
Other
Person #4 Ethnicity
Hispanic or Latino
Non-Hispanic and Non-Latino
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Additional Persons in Household
Person #5
Name of Person #5
First Name
Last Name
Is Person #5 Disabled?
Yes
No
Person #5 Gender
Female
Male
Person #5 Date of Birth
-
Month
-
Day
Year
Date
Person #5 Social Security Number (enter 000-00-0000 if unknown)
Person #5 Race
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Other Pacific Islander
White
American Indian / Alaskan Native & White
Asian & White
Black / African American & White
American Indian / Alaskan Native & Black / African American
Other
Person #5 Ethnicity
Hispanic or Latino
Non-Hispanic and Non-Latino
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Household Assistance Program Participation Information
Does anyone in the household receive ... (choose all that apply)
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Medicare
Medicaid
Employer Provided Insurance
Insurance Paid for Out-of-Pocket
CHIP
SNAP
WIC
LIHEAP Utility Assistance
Illinois Child Care Assistance Program (CCAP)
RTA Free / Reduced Fare Programs
FCC Lifeline for Internet OR Phone
Affordable Connectivity Program (ACP) for reduced internet costs
Housing Voucher with Lake County Housing Authority
Housing Voucher with Waukegan Housing Authority
Housing Voucher with North Chicago Housing Authority
None of the Above
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Income and Expenses
Please Record All Sources of Income for the ENTIRE household:
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Rows
Amount Per MONTH
Wages from Employment
Social Security or Disability
Unemployment
Child Support
Regular Cash Gifts
TANF
Housing Choice Voucher
VA Benefits (active duty)
VA Benefits (retired)
Other
Please Record Expenses for the ENTIRE household:
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Rows
Amount Per MONTH
Rent
Renters Insurance
Car Payment
Auto Insurance
Gas
Bus or Train Fare
Uber / Lyft
Cell Phone
Internet
Natural Gas
Electricity
Garbage / Water / Sewer
Groceries / Household Goods
Childcare or Eldercare
Education / Tuition
Prescription Drugs
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I am applying for (CHOOSE ONLY ONE)
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Delinquent Rent ONLY.
Security Deposit ONLY.
BOTH Delinquent Rent AND Security Deposit.
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To apply for Delinquent Rent:
I attest that without assistance with delinquent rent, my housing with be subject to eviction and therefore will be at risk of homelessness.
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Yes. Without assistance, my household will be at risk for homelessness.
Current Landlord's OR Property Manager’s Name
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First Name
Last Name
Current Landlord's OR Property Manager’s Email
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example@example.com
Current Landlord's OR Property Manager’s Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Current Amount of Monthly Rent per Lease
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Amount of Tenant's Portion (for Voucher Holders ONLY)
Amount of Rent Currently Owed
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To Apply for Security Deposit
I attest that without Security Deposit Assistance, I will not be able to secure housing, and will therefore be at risk for homelessness.
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Yes. Without assistance, my household will be at risk for homelessness.
FUTURE Address where security deposit is needed:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
FUTURE Landlord's OR Property Manager’s Name
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First Name
Last Name
FUTURE Landlord's OR Property Mananger's Email
*
example@example.com
FUTURE Landlord's OR Property Mananger's Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
FUTURE Amount of Monthly Rent per Lease
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Amount of Tenant's Portion (for Voucher Holders ONLY)
Amount of Security Deposit
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What date will you be moving in?
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Month
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Day
Year
Date
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I hereby verify that I have received Fair Housing information/material regarding rights and remedies available under federal, state, and local fair housing and civil rights laws. Counseling services and other forms of assistance that may be offered by Lake County Housing Authority, its affiliates or directors, officers, employees, agents or partners may also be offered by other providers. You are under no obligation to utilize services from Lake County Housing Authority, regardless of the recommendations made by counselors. Housing Counseling clients are not obligated to use any program or service offered by LCHA, their affiliates or partners. The Office of Housing Counseling will provide information on alternative programs and services. Clients should consider a variety of options and select the resources that best addresses their needs. Signature
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Please read the following Disclosure to Client and Privacy Policy
I have read and received a copy of the disclosures (pages 1 & 2)
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LCHA's Privacy Policy
Please read LCHA's Privacy Policy regarding your nonpublic personal information:
Regarding your nonpublic personal information:
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OPT-OUT: I request that LCHA make no disclosures of my nonpublic personal information to third parties other than project partners and those permitted by law. By choosing this option, I understand that LCHA will NOT be able to answer any questions from my creditors. I understand that I may change my decision any time by contacting LCHA.
OPT IN / RELEASE: I hereby authorize LCHA to release nonpublic personal information it obtains about me to my creditors and any third parties necessary to provide me with the services I requested. I acknowledge that I have read and understand the above privacy practices and disclosures.
Privacy Policy & Ability to OptOut: I have read and received a copy of LCHA's HSCP Authorization and Disclosure as well as the Privacy Policy, including my option to opt out of the above terms and the release/disclosure ofany nonpublic, personal information.
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Today's Date
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Month
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Day
Year
Date
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Please read the following Authorization to Share Information Using ServicePoint
Is the person signing a minor?
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Yes
No
Name of Person Signing
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First Name
Last Name
This Authorization expires on (please choose a date one or more years from today)
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Month
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Day
Year
Date
I have read and understand the above material and I hereby consent that Lake County and the Participating Agencies use, disclose, enter, transmit, and share the Protected Health Information for me or my child(ren)/ward(s)/dependent(s) identified below using ServicePoint® and, if I am between the ages of 13-17, to share Protected Health Information with my parent or guardian.
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Document Uploads
All applicants are required to submit a lease, proof of income, proof of residency, and proof of temporary, economic crisis. Your application will not be reviewed until all documents are received. You can upload documents to this application or email / fax these to your TAP case manager. OTHER DOCUMENTS MAY BE REQUESTED ON A CASE-BY-CASE BASIS.
Lease for the unit where you are applying for assistance
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Ledger of Rents Owed (for those applying for delinquent rent)
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Proof of Identification for the Head of Household
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RFTA for FUTURE Unit (for voucher holders only)
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Income Documentation
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Proof of Residency
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Proof of Crisis or Hardship
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