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Chatham County, GA

helpdesk@chathamcounty.org

222 W. Oglethorpe Ave, Suite 273, Savannah, GA, 31401, US

912-652-7343

Chatham County Emergency Rental Assistance Program Pre-application form

To be eligible, you must answer yes and provide proof that you meet the eligibility criteria.

Please prepare the documentation and upload them at the end of the questionnaire, or provide them to the agent that will take care of your application (check the links below):

Microsoft Word - LIST OF REQUIRED DOCUMENTS TO APPLY FOR RENTAL ASSISTANCE.docx (windows.net)

Microsoft Word - LIST OF REQUIRED DOCUMENTS TO APPLY FOR RENTAL ASSISTANCE - Landlord.docx (windows.net)

Your application will be processed more quickly if you can provide the required documentation at the time you submit this form. 

WARNING!

In signing this document (including electronic signature), you are acknowledging that falsification of documents or any material falsehoods or omissions in the Application, including knowingly seeking duplicative benefits, is subject to state and federal criminal penalties. You are particularly put on notice that the Title 18, Section 1001 of the U.S. Code, provides among other things, that whoever knowingly and willingly makes or uses a document or writing containing any false, fictitious, or fraudulent statement or entry, in any matter within the jurisdiction of any department or agency of the United States will be fined not more than $10,000 or imprisoned for not more than five years, or both.

Do you live in Chatham County?

We are sorry! You are not eligible for the Chatham County Emergency Rental Assistance Program.

Type of applicant:

Do you have an open application with other Service Provider and/or have been assisted before by another Service Provider? If so, please indicate the Organization's name:

Tenant Full Name

Full Address

Gender

Race - Ethnicity

Is the household income less than $72,000 per year? (A household is everyone living in your home, including you)

We are sorry! You are not eligible for the Chatham County Emergency Rental Assistance Program.

Are you or your household required to pay rent and/or utilities?

We are sorry! You are not eligible for the Chatham County Emergency Rental Assistance Program.

Have one or more individuals within the household qualified for unemployment benefits or experienced a reduction in household income, incurred significant costs, or experienced other financial hardship due, during, directly or indirectly, to the COVID-19 outbreak?

We are sorry! You are not eligible for the Chatham County Emergency Rental Assistance Program.

Can one or more individuals residing within the household demonstrate a risk of experiencing homelessness or housing instability including a past due utility or rent notice or an eviction notice, unsafe or unhealthy living conditions, or any other evidence of risk?

We are sorry! You are not eligible for the Chatham County Emergency Rental Assistance Program.

Do you have an eviction notice? If yes, please indicate the court date and upload the document in order to prioritize your application.

You are eligible! Please upload the documentation and submit the form, one of our Service Providers will contact you to complete the application. If you are unable to upload the documentation, please submit and print this form and present it with the documents to the agent that will be assigned to your case. Thank you.

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