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Emergency Rental Assistance Exception Request Form

For Program Admins of the ERA program only.

1 of 7 Request Form Purpose

This exception request form is intended for use by contracted nonprofit providers who are seeking approval to offer financial assistance to a client in a manner that falls outside the original contract terms. This may include:

  • Exceeding the maximum rental assistance amount per client of 100-120% of the applicable HUD FMR
  • Covering more than six months of rent within a 12-month period or more than 18 months of rent within a 36-month period
  • Other complex circumstances that may affect the client's housing stability (e.g., urgent eviction, health crisis, undocumented income, DV, etc.)
     

Please do not include client names, birthdays, social security numbers, or any other personally identifiable information in your form submission.

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