Assistance Intake Form

Complete the form below to request a 48-hour eligibility review.

Additional Information

Briefly describe your situation

Upload Government ID

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Mortgage Statement

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Tax Notice

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Foreclosure Notice

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Property Deed

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Contracts or Agreements

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload Probate Documents

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Upload THA Authorization Forms

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Please upload any documents you currently have available.

If you do not have a document yet, you may leave it blank.

You may upload up to 10 documents. Accepted file types: PDF, JPG, PNG, DOC, DOCX.

Program Eligibility Review:
Submission of this form does not guarantee program eligibility or financial assistance. All requests are reviewed based on program guidelines and availability of resources.

Submission Notice:
Submission of this form does not create a client relationship and does not guarantee services, assistance, or funding.

A Nonprofit Organization

Assistance Intake Form

Complete the form below to request a 48-hour eligibility review.

Additional Information

Please upload any documents you currently have available.

Housing Advocacy and Assistance for Property Owners Facing Financial or Property Distress