PROGRAM APPLICATION
TOWN OF BROOKHAVEN HOME ARP RENTAL ASSISTANCE PROGRAM

FIRST – COME FIRST – SERVED PROGRAM GUIDELINES

 

TOWN OF BROOKHAVEN HOME ARP   

RENTAL ASSISTANCE PROGRAM


PROGRAM SUMMARY:

The Town of Brookhaven (the “Town”) Rental Assistance Program (the “Program”) is intended to provide rental assistance to foster housing stability to “Qualifying Populations.”    The Long Island Housing Partnership (“LIHP”) has been retained to administer the Program. The funds are provided through the U.S. Department of Housing and Urban Development (“HUD”), pursuant to the American Rescue Plan.  There are limited funds available.  Therefore, the program will be first-come first-served until the funds are exhausted

 

APPLICATIONS MAY ONLY BE SUBMITTED ONLINE BEGINNING AT 11:00 AM ON AUGUST  1, 2024.
THE SUBMISSION PERIOD WILL BE OPEN UNTIL FURTHER NOTICE.  PLEASE CONSULT LIHP’S WEBSITE FOR UPDATED INFORMATION.


If you have any questions regarding any of the Program Guidelines, or need language or other assistance, including translation and/or oral interpretation services, please email LIHP at info@lihp.org before applying. Si tiene alguna pregunta con respecto a cualquiera de las Pautas del Programa, o necesita asistencia lingüística o de otro tipo, incluidos servicios de traducción y/o interpretación oral, por favor envíe un correo electrónico a LIHP a info@lihp.org antes de presentar la solicitud.


DISCLAIMERS:

The submission of an Application or other documents for this program does not constitute acceptance, approval of minimum qualification criteria, or a guarantee of a program award.  All information and documentation must be subsequently submitted and reviewed for eligibility.  Households who provide misleading or false information or who apply more than once for the program (even under a different family member) will be disqualified.

 

The Program Guidelines and criteria are based upon current requirements and guidance issued by HUD and approved by the Town.  Applicants are advised that the Program Guidelines are subject to change, at any time and from time to time, without prior notice, based upon needs, requirements, interpretations, and regulations, as the same may be determined by HUD and/or the Town.  LIHP and/or the Town may request additional or different documentation as may be acceptable to the Town/LIHP in their sole discretion.  Awards are subject to funding availability whether or not a notice of award was provided.


TYPES OF RENTAL ASSISTANCE:

Rental assistance will be available as follows:

1)         Supportive services in the form of Rental Arrears and Late Fees (6-month maximum; accrued arrears payable in 1 lump sum payment)

2)         Tenant Based Rental Assistance in the form of Prospective Rent Payments (12-month maximum, payable in monthly installments)

3)         Tenant Based Rental Assistance in the form of Rental Security Deposits (1-month maximum)

 

NOTE: Applicants cannot receive both arrears assistance and prospective rent/security deposit assistance.


NOTE: Applicants seeking Prospective Rent Assistance under the category of “At-Risk of Homelessness (QP-2)” or “Other Populations (QP-4)” and who are in arrears on their current residence will only be reviewed for Prospective Rent if they have received a Notice of Eviction for their current residence. 

 

QUALIFYING POPULATIONS:

An applicant must be a member of one of the following Qualifying Populations (QP):

QP1:    Homeless (pursuant to 24 CFR 91.5 (1), (2) and (3))

QP2:    At-Risk of Homelessness as defined at 24 CFR 91.5

QP3:    Fleeing, or Attempting to Flee, Domestic Violence, Dating Violence, Sexual Assault,

            Stalking, or Human Trafficking

QP4:    Other Populations


Each of the above QPs is further defined on Schedule A.


APPLICANT ELIGIBILITY REQUIREMENTS:

  • Applicants must be a member of a Qualifying Population (as defined below). LIHP will verify such status
  • Applicant must currently reside or will reside in a rental unit in the Town of Brookhaven (including Villages)
  • If income limits apply, applicant must have household income at or under the required Area Median Income (“AMI”) for Nassau/Suffolk County as established by HUD and adjusted for household size, at the time assistance is received. Please see the chart below under INCOME LIMITS
  • Applicants must be a US citizen or Qualified Alien, as defined at 8 USC 1641

INELIGIBLE APPLICANTS:

The following applicants are ineligible to receive assistance under the Program:

  • Employees or agents of LIHP, the landlord, or the landlord’s property management company
  • Applicants who are related to the landlord or any principal of the landlord or property management company by blood or marriage
  • Employees or agents of the Town
  • For prospective rent and security deposits only - Participants who receive a rental housing subsidy.  This includes but is not limited to: Section 8 Housing Choice Voucher Program, Project Based Housing, Public Housing, or other government-based rental assistance programs, such as VASH (Veterans Affairs Supportive Housing). Households with a rental housing subsidy who have suffered a loss of income should contact their housing voucher provider for assistance.


RENT CAP:

Rent for the unit cannot exceed the monthly amount set forth below based on the 2024 HUD Fair Market Rent Standard by unit type.  


Efficiency

One Bedroom         

Two Bedroom      

Three Bedroom

Four Bedroom

$1,878

$2,358

$2,758

$3,571

$3,873

 

If unit rent exceeds the amounts set forth above, the applicant will be removed from the waitlist and the file closed.  The maximum rents are subject to change without notice as per Town requirements. Any such change will be applicable for applications for which a final determination has not been issued and shall not apply to any applications for which a final determination of eligibility has been issued (unless the Town determines otherwise).


UNIT REQUIREMENTS:

  •         Rental unit must be located in the Town of Brookhaven (including Villages)
  •         The unit must have a valid rental permit or operational authority issued by the Town or applicable municipality. The Town will verify.
  •         The unit must meet Lead Based Paint (“LBP”) inspection criteria as required by the Town and HUD, if applicable.  The Town will assess as applicable.
  •         The unit must comply with all housing quality standards (“HQS”) required by HUD and/or set forth at 24 CFR 982.401.  For units that are HOME or HOME ARP assisted, the Town may rely upon a current HQS inspection issued by a HUD certified HQS inspector. The Town and/or its authorized agents will conduct the HQS inspections. The town, and/or their agents, must be provided access to the premises and unit for purposes of performing HQS inspections.
  •         Single room occupancy units are not eligible under the Program


LEASE REQUIREMENTS:

·         For arrears: The Lease may be oral or written.  If the Lease is written, a current fully executed copy must be provided. If the Lease is oral, the agreement and the rent owed must be documented by the owner's financial records, rent ledgers, or canceled checks [see 24 CFR 576.106 (g)]

·         For prospective rent and Security Deposit: A written lease for a period of not less than one year must be executed by tenant and landlord

·         For all assistance: A Lease Addendum must be executed by tenant and landlord that includes all requirements that apply to tenants, the owner or the Lease under 24 CFR part 5, subpart L (Protection for Victims of Domestic Violence, Dating Violence, Sexual Assault, or Stalking), as supplemented by 24 CFR 576.409, including the prohibited bases for eviction and restrictions on construing lease terms under 24 CFR 5.2005(b) and (c).


REQUIREMENTS FOR ASSISTANCE:

  •        The landlord is required to participate and to submit a Landlord Participation Agreement
  •        The landlord and tenant must execute a Rental Assistance Agreement with the Town to participate in the Program. The Rental Assistance Agreement will set forth the terms under which the   assistance will be provided and will contain other required provisions including a requirement that the landlord provide LIHP and the Town with a copy of any notice to the tenant to vacate or to evict.
  •        Landlord and tenant must execute the Lease Addendum
  •        Landlord must also provide the following documents:
            - W-9 Form
            - Current Rent Ledger (if applicable)
     

PAYMENT TERMS:

Payment will be made directly from the Town and only to the owner of record as verified by the Town. Security deposits must be maintained by owner in a separate interest-bearing account pursuant to all applicable laws.

 

  •        Arrears:  A one-time lump-sum payment of up to 6-months of rental arrears may be paid, including any late fees on the arrears.
  •        Prospective Rent:  Monthly payments following written confirmation from owner that tenant still resides in the unit
  •        Security Deposit:  A one-time lump-sum payment for up to one-months’ rent
  •        Final funding of award under the Program is subject to approval of the Town.
  •        There can be no duplication of benefits.  Please see the section entitled “DUPLICATION OF BENEFITS.”


DOCUMENTATION REQUIREMENTS FOR QUALIFYING POPULATIONS:

Applicants are required to provide documentation necessary to verify their status as a member of a Qualifying Population. LIHP shall request such documentation as it may deem necessary or desirable including, without limitation, the documentation and verification requirements set forth in the attached HUD HOME ARP QUALIFYING POPULATIONS: DOCUMENTATION REQUIREMENTS MANUAL attached as Schedule BDuring the application process, applicants will be contacted by LIHP and/or its program partners, to obtain such documentation and to verify status.

 

PROGRAM PARTNERS:

 

LIHP has engaged with the following organizations to assist with applicant review and eligibility: Brighter Tomorrows, Inc. and Long Island Coalition for the Homeless.

 

Long Island Coalition for the Homeless                                           Brighter Tomorrows

600 Albany Avenue                                                                             P.O Box 706

Suite 2                                                                                                  Shirley, NY 11967

Amityville, NY 11701                                                                          (631) 395-1800 ext. 110

(631) 464-4314


INCOME LIMITS (IF APPLICABLE):

Funds are intended to primarily benefit households based on their status as "Qualifying Populations,” without meeting additional criteria (such as additional income criteria). However, if income limits apply, please see chart below.

 

Household Size

1

2

3

4

5

6

7

8

30%

$32,800

$37,500

$42,200

$46,850

$50,600

$54,350

$58,100

$61,850

50%

$54,700

$62,500

$70,300

$78,100

$84,350

$90,600

$96,850

$103,100

 

Income includes all gross household income – earned income/wages, overtime, unemployment, bonuses, pensions, social security, 401K distributions, tips, interest on bank accounts, etc.  Income cannot exceed the maximum annual income for your household sizeThe limits above are based on the 2024 HUD “uncapped” income limits and will be automatically adjusted upon issuance of updated HUD income limits.  Income limits are subject to adjustment for rounding and annual reassessment.  The foregoing is subject to change as per HUD and the Town without notice.   Income is determined at the time of assistance and will be projected forward 12-months


Household income of HOME-ARP rental unit tenants must be determined following the requirements at 24 CFR 5.609 (Section 8/HCV income calculation) unless the household is assisted by a state or federal project based rental subsidy or receiving federal tenant-based rental assistance. When a unit is assisted by a state or federal project-based rental subsidy or a household is receiving a federal tenant-based subsidy (e.g., Housing Choice Voucher), then the income determination of the public housing agency or Section 8 project owner will be accepted.


FIRST-COME FIRST-SERVED APPLICATION PROCESS:

As funds are limited, Applications will be accepted on a first-come first-served basis.  To be placed on the waitlist and ranked for eligibility for the Program, applicants must apply and submit documentation within the required timeframe. Applications are available as set forth below.  Applicants who submit the Application within the time required will be “conditionally” placed on the waitlist in the order received.  Submission of the Application does not guarantee eligibility for the Program.   


WHERE TO GET AND HOW TO SUBMIT AN APPLICATION:

Applications are available online at www.lihp.org/BrookhavenRentalAssistance.html. Only one Application is allowed per household.

 


ELIGIBILITY REVIEW PROCESS:

During each Step, LIHP and/or its program partners may request additional information and/or documentation to verify applicant eligibility. Applicant will be required to comply with such requests and any timeframes established to provide such information/documentation or applicant will be deemed ineligible, subject to a right to appeal (if applicable). 

 

Step 1: Submission of Application and Documentation

Each applicant must submit the following initial documentation:

1)      Completed Application

2)      Copy of a valid driver’s license or valid photo ID for the Applicant

3)      Copy of Qualified Alien status, if not a U.S. citizen

 

Step 2: Review of Status and Eligibility as Qualifying Population

The applicant will be initially reviewed for preliminary Program eligibility based upon information provided in the Application.

 

This will involve contacting the applicant and/or their caseworkers to clarify their situation and needs as well as requiring additional documentation, as LIHP shall determine, including, without limitation, self-certification as to status within a Qualifying Population.  If income limits apply to the applicants, then income documentation will be requested and reviewed. If other household members are identified then documentation regarding such household members may be requested. During this process, LIHP may engage one of its program partners to assist with outreach to the applicant and verification of status.

 

If determined to be ineligible, LIHP will notify the applicant by email and the applicant will be deemed ineligible, subject to a right to appeal. If eligible, applicant will be deemed to be “Preliminarily Eligible” and shall proceed to Step 3.

 

 

Step 3 – Landlord Participation/Verification of Valid Rental Permit

 

            Step 3 (a): For Applicants with Existing Leases- Landlord Participation

 

            For applicants with existing leases or rental obligations, LIHP will contact the landlord      stated in the Application who will be required to submit a Landlord Participation Agreement and required documentation, as applicable (e.g., Current rent ledger, W-9 Form, current lease)

 

            Landlord will then have ten (10) calendar days from the date of the notice from LIHP to  submit ALL such documentation to LIHP.    If ALL required documentation is not received   by LIHP within the timeframe required, then applicant will be removed from the waitlist and the file closed.  Applicant will be notified of removal from the waitlist by email.


            NOTE: Failure of the existing landlord to participate by submitting the Landlord  Participation Agreement within the stated timeframe is NOT appealable.

           

            Step 3 (b): For Applicants with No Existing Lease - Landlord Participation

 

            For applicants with no existing lease, applicants are required to identify a rental unit and landlord that meets the Program requirements within a 60-calendar day period of notice that they are Preliminarily Eligible.  LIHP may engage with its program partners who will work with applicant to identify a rental unit and landlord that meets the Program requirements.

 

            Once identified, LIHP will contact the landlord who will be required to submit a Landlord             Participation Agreement and required documentation, as applicable (i.e., W-9 Form)

 

            Landlord will then have ten (10) calendar days from the date of the notice from LIHP to submit ALL such documentation to LIHP.  If ALL required documentation is not received by LIHP within the timeframe required, then such landlord will be deemed non-responsive and the file closed with respect to such landlord.  

 

            If no unit/landlord can be identified for applicant within the required 60-day period then             the applicant will be removed from the waitlist and the file closed.  Applicant will be notified of removal from the waitlist by email.


            NOTE: Failure to identify a unit/landlord or failure of a landlord to participate by     submitting the Landlord Participation Agreement within the stated timeframe is NOT appealable.

 

           

            Step 3(c):  - Valid Rental Permit

 

            For all rental units, LIHP will coordinate with the Town to obtain verification by the Town or applicable municipality of a valid rental permit or authority to operate as a rental/housing unit.  The Town will provide such verification in writing to LIHP.  If no valid permit exists, then: (a) If applicant has an existing lease, the applicant will be deemed ineligible and will be removed from the waitlist and notified by email; or (b) if applicant does not have an existing lease, only the unit will be deemed ineligible but applicant may identify an alternate unit provided it is within the original 60 calendar day period referenced above.

 

            NOTE: Absence of a valid rental permit is NOT appealable.

     

Step 4: Unit Inspection

If Steps 1, 2 and 3 are completed and applicant is still eligible, Town will perform an HQS/Lead Based Paint Inspection, if applicable.  If the unit fails inspection, landlord must complete the required repairs including lead-based paint clearance, at landlord’s sole expense, within thirty (30) days of determination, otherwise the landlord and the unit will be deemed ineligible for the Program.  If unit cannot pass inspection then: (a) If applicant has an existing lease, the applicant will be deemed ineligible and will be removed from the waitlist and notified by email; or (b) if applicant does not have an existing lease, only the unit will be deemed ineligible but applicant may identify an alternate unit provided it is within the original 60calendar day period referenced above.

 

NOTE: Failure to comply with Step 4 within the stated timeframe is NOT appealable.

 

Step 5: Assessment of Conditional Award

If Steps 1, 2, 3, and 4 are successfully completed (and any discrepancies are resolved), an assessment of unmet need, a duplication of benefits review, and a calculation of a conditional award will be made by LIHP for review and approval by the Town.  Landlord may be requested by LIHP to provide a current rent ledger (if applicable) in order to establish a conditional award of arrears.

 

NOTE:  Any discrepancies must be resolved prior to any determination of Conditional Award.  See section below entitled “DISCREPANCIES.” 

 

Step 6: Conditional Award Documentation

Upon successful completion of Step 5, LIHP will contact the landlord, applicant, and Town by email to advise of the conditional award amount and to request the execution and delivery of the following final documentation:

 

·         Rental Assistance Agreement

·         Lease Addendum

·         Copy of executed Lease (if applicable)

 

The signed documentation must be returned to and received by LIHP within ten (10) calendar days from the date of the notice from LIHP. If required documentation is not received by LIHP within the timeframe required, the applicant will be deemed ineligible, subject to a right to appeal.  Applicant and the landlord will be notified of ineligible status from the waitlist by email.

 

Step 7: Final Documentation and Award

If Step 6 is successfully completed, the conditional award will convert to a final award.   LIHP will provide the applicant and the landlord with the documentation (sent by email) confirming the award and a check will be mailed to the landlord by the Town.

 

DISCREPANCIES:

Applicants are advised that if a discrepancy or question arises concerning status, the identity of the landlord, the amount of arrears, the rent, or other relevant information exists that cannot be reconciled by LIHP from the documentation provided, such discrepancy must be resolved to the satisfaction of LIHP and/or the Town within the time frame provided by LIHP. Any such discrepancy or question that is not so resolved within the time frame required will result in applicant ineligibility, subject to appeal, as applicable.

 

If there is no discrepancy, including in the amount of arrears if applicable, then the amount of the Program award will be based on the documentation submitted.


APPEALS:

Applicants who are deemed ineligible may appeal the determination by submitting a request to LIHP. The appeal request must be in writing and must be received (together will all documentation) by LIHP within five (5) calendar days of the date of LIHP’s notice to applicant of the determination of ineligibility.  The appeal must state the basis of the appeal and contain documentation to support the appeal.  Please note that, if the applicant was deemed ineligible due to failure to submit required documentation within the required time frame, then, no appeal will be granted unless the applicant submits the remaining required documentation with the appeal letter/request within the timeframe required.  The appeal will be promptly reviewed and the applicant advised of the final determination by email. 

 

Notice to LIHP of an appeal request can ONLY be submitted via a file-specific link that will be provided by LIHP during this Step.

 

NOTE: Ineligibility due to non-compliance with Step 3 or Step 4 is NOT appealable.  The determinations are final and non-appealable.

 

DUPLICATION OF BENEFITS:

Federal law prohibits any duplication of benefits.  A duplication of benefits occurs when a person or entity receives financial assistance from multiple sources for the same purpose and the total assistance is more than the total need.  Applicants and landlords will be required to sign a certification regarding duplication of benefits.  If additional funds are received and determined to be duplicative, the amount of the award, if eligible, may be reduced and the amount disbursed that is determined to be a duplication of benefits must be repaid.  The obligation to pay any duplication of benefits is an on-going obligation.  If awarded funds, the beneficiaries may be required to recertify, from time to time as requested by the Town, but in no event later than 12 months from award, as to whether additional funds have been received.

 

To assess duplication of benefits, and the unmet need, the Town is requiring the following process to be followed:

·         Assess Need: Total need for assistance will be assessed (the “Total Need”).

·         Determine Assistance: The amount of assistance that has or will be provided from all sources to pay the need will be reviewed.

·         Calculate Unmet Need: Determine the amount of assistance already provided compared to the Total Need to determine the Unmet Need.

·         Apply Program Cap, if applicable

·         Document Analysis

 

VIOLATION OF FEDERAL LAW:

THE INFORMATION PROVIDED BY HOUSEHOLDS MUST BE TRUE AND CORRECT. THE INFORMATION PROVIDED IS SUBJECT TO VERIFICATION BY THE TOWN AND/OR HUD. BY SUBMITTING AN APPLICATION AND SUPPORTING DOCUMENTS, THE APPLICANT ACKNOWLEDGES AND UNDERSTANDS THAT TITLE 18 OF THE UNITED STATES CODE SECTION 1001: (1) MAKES IT A VIOLATION OF FEDERAL LAW FOR A PERSON TO KNOWINGLY AND WILLFULLY (A) FALSIFY, CONCEAL, OR COVER-UP A MATERIAL FACT; (B) MAKE ANY MATERIALLY FALSE, FICTITIOUS, OR FRAUDULENT STATEMENT OR REPRESENTATION; OR (C) MAKE OR USE ANY FALSE WRITING OR DOCUMENT KNOWING IT CONTAINS A MATERIALLY FALSE, FICTITIOUS OR FRAUDULENT STATEMENT OR REPRESENTATION, TO ANY BRANCH OF THE UNITED STATES GOVERNMENT; AND (2) REQUIRES A FINE, IMPRISONMENT FOR NOT MORE THAN FIVE (5) YEARS, OR BOTH, WHICH MAY BE RULED A FELONY, FOR ANY VIOLATION OF SUCH SECTION.


FAIR HOUSING AND NON-DISCRIMINATION:

LIHP is committed to furthering and promoting fair housing, equal opportunity, and non-discrimination in compliance with all federal, state and local laws, including, but not limited to, the Fair Housing Act, as amended by the Housing for Older Americans Act, the Americans with Disabilities Act, the Civil Rights Act, and the New York State Human Rights Law.  LIHP will have staff available to assist with the Application, and answer questions about eligibility requirements.  In furtherance of this policy, LIHP will not discriminate on the basis of race, creed, color, national or ethnic origin, sex, sexual orientation, gender identity, familial status, source of income, religion, disability, veterans’ status, age, or any other basis prohibited by law.

 

LIMITED ENGLISH PROFICIENCY AND ACCOMMODATIONS:

Applications and Program Guidelines will be made available in other languages as requested. LIHP will take reasonable steps to ensure that persons with Limited English Proficiency (LEP) and persons, who need assistance or who have a limited ability to speak, read, or write English, will have meaningful access and an equal opportunity to participate in the Program.  Interpreters, translators and other aids needed to comply with this policy shall be provided as reasonably necessary. 


SCHEDULE A -QUALIFIED POPULATIONS


QP1:    HOMELESS (pursuant to 24 CFR 91.5 (1), (2) and (3)) is

                (1) An individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:

                     (i) An individual or family with a primary nighttime residence that is a public or private                         place not designed for or ordinarily used as a regular sleeping accommodation for                                  human beings, including a car, park, abandoned building, bus or train station, airport, or                                      camping ground;

                     (ii) An individual or family living in a supervised publicly or privately operated shelter                            designated to provide temporary living arrangements (including congregate      shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state, or local government programs for low-income individuals); or

                     (iii) An individual who is exiting an institution where he or she resided for 90 days or less                     and who resided in an emergency shelter or place not meant for human habitation                                immediately before entering that institution;

           (2)          An individual or family who will imminently lose their primary nighttime residence, provided that:

                     (i) The primary nighttime residence will be lost within 14 days of the date of application                       for homeless assistance;

                     (ii) No subsequent residence has been identified; and

                     (iii) The individual or family lacks the resources or support networks, e.g., family,                                    friends, faith-based or other social networks needed to obtain other permanent                                                      housing;

           (3)          Unaccompanied youth under 25 years of age, or families with children and youth, who    do not            otherwise qualify as homeless under this definition, but who:

                     (i) Are defined as homeless under section 387 of the Runaway and Homeless Youth                            Act (42 U.S.C. 5732a), section 637 of the Head Start Act (42 U.S.C. 9832), section 41403 of the Violence Against Women Act of 1994 (42 U.S.C. 14043e–2), section 330(h) of the Public Health Service Act (42 U.S.C. 254b(h)), section 3 of the Food and Nutrition Act of 2008 (7 U.S.C. 2012), section 17(b) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)), or section 725 of the McKinney-Vento Homeless Assistance Act (42 U.S.C.                                      11434a);

                     (ii) Have not had a lease, ownership interest, or occupancy agreement in permanent                             housing at any time during the 60 days immediately preceding the date of application                          for homeless assistance;

                     (iii) Have experienced persistent instability as measured by two moves or more during                         the 60-day period immediately preceding the date of applying for homeless assistance;                                  and

                      (iv) Can be expected to continue in such status for an extended period of time because                       of chronic disabilities, chronic physical health or mental health conditions, substance                            addiction, histories of domestic violence or childhood abuse (including neglect), the                              presence of a child or youth with a disability, or two or more barriers to employment,                                     which include the lack of a high school degree or General Education Development                                               (GED), illiteracy, low English proficiency, a history of incarceration or detention for                                               criminal activity, and a history of unstable employment.


QP2:    AT-RISK OF HOMELESSNESS

As defined in 24 CFR 91.5, at risk of homelessness means:

 (1) An individual or family who:

      (i) Has an annual income below 30 percent (30%) of median family income for the area, as determined by HUD;

      (ii) Does not have sufficient resources or support networks, e.g., family, friends, faith based or other social networks, immediately available to prevent them from moving to an emergency shelter or another place described in paragraph (1) of the “Homeless” definition at 24 CFR 91.5; AND

                (iii) Meets one of the following conditions:

                                (A) Has moved because of economic reasons two or more times during the                                   60 days immediately preceding the application for homelessness prevention assistance;

 

                                (B) Is living in the home of another because of economic hardship;

 

                                (C) Has been notified in writing that their right to occupy their current housing                                             or living situation will be terminated within 21 days after the date of application for assistance;

 

                                (D) Lives in a hotel or motel and the cost of the hotel or motel stay is not paid by charitable organizations or by federal, State, or local government programs for low-income individuals;

 

                                (E) Lives in a single-room occupancy or efficiency apartment unit in which there reside more than two persons or lives in a larger housing unit in which there reside more than 1.5 people per room, as defined by the U.S. Census Bureau;

 

                                (F) Is exiting a publicly funded institution, or system of care (such as a health-care facility, a mental health facility, foster care or other youth facility, or correction program or institution); or

 

                                (G) Otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness, as identified in the recipient's approved consolidated plan; 

 

(2) A child or youth who does not qualify as “homeless” under this section, but qualifies as “homeless” under section 387(3) of the Runaway and Homeless Youth Act (42 U.S.C. 5732a(3)), section 637(11) of the Head Start Act (42 U.S.C. 9832(11)), section 41403(6) of the Violence Against Women Act of 1994 (42 U.S.C. 14043e-2(6)), section 330(h)(5)(A) of the Public Health Service Act (42 U.S.C. 254b(h)(5)(A)), section 3(l) of the Food and Nutrition Act of 2008 (7 U.S.C. 2012(l)), or section 17(b)(15) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(b)(15)); OR

 

(3) A child or youth who does not qualify as “homeless” under this section but qualifies as “homeless” under section 725(2) of the McKinney-Vento Homeless Assistance Act (42 6 U.S.C. 11434a(2)), and the parent(s) or guardian(s) of that child or youth if living with her or him.

 

QP3:    FLEEING, OR ATTEMPTING TO FLEE, DOMESTIC VIOLENCE, DATING VIOLENCE, SEXUAL ASSAULT, STALKING, OR HUMAN TRAFFICKING


For HOME-ARP, this population includes any individual or family who is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or human trafficking. This population includes cases where an individual or family reasonably believes that there is a threat of imminent harm from further violence due to dangerous or life-threatening conditions that relate to violence against the individual or a family member, including a child, that has either taken place within the individual’s or family’s primary nighttime residence or has made the individual or family afraid to return or remain within the same dwelling unit. In the case of sexual assault, this also includes cases where an individual reasonably believes there is a threat of imminent harm from further violence if the individual remains within the same dwelling unit that the individual is currently occupying, or the sexual assault occurred on the premises during the 90-day period preceding the date of the request for transfer.

 

 Domestic violence, which is defined in 24 CFR 5.2003 includes felony or misdemeanor crimes of violence committed by:

1) A current or former spouse or intimate partner of the victim (the term “spouse or intimate partner of the victim” includes a person who is or has been in a social relationship of a romantic or intimate nature with the victim, as determined by the length of the relationship, the type of the relationship, and the frequency of interaction between the persons involved in the relationship);

2) A person with whom the victim shares a child in common;

3) A person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner;

4) A person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction receiving HOME-ARP funds; or

5) Any other person against an adult or youth victim who is protected from that person's acts under the domestic or family violence laws of the jurisdiction.

 

Dating violence which is defined in 24 CFR 5.2003 means violence committed by a person:

1) Who is or has been in a social relationship of a romantic or intimate nature with the victim; and

2) Where the existence of such a relationship shall be determined based on a consideration of the following factors:

a. The length of the relationship;

b. The type of relationship; and

c. The frequency of interaction between the persons involved in the relationship.

 

Sexual assault which is defined in 24 CFR 5.2003 means any nonconsensual sexual act proscribed by Federal, Tribal, or State law, including when the victim lacks capacity to consent.

Stalking which is defined in 24 CFR 5.2003 means engaging in a course of conduct directed at a specific person that would cause a reasonable person to:

1) Fear for the person’s individual safety or the safety of others; or

2) Suffer substantial emotional distress.

Human Trafficking includes both sex and labor trafficking, as outlined in the Trafficking Victims Protection Act of 2000 (TVPA), as amended (22 U.S.C. 7102). These are defined as:

 

            1) Sex trafficking means the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act, in which the commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age; or

 

            2) Labor trafficking means the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

 

QP4:    OTHER POPULATIONS where providing supportive services or assistance under section   212(a) of NAHA (42 U.S.C. 12742(a)) would prevent the family’s homelessness or would      serve those with the greatest risk of housing instability. HUD defines these populations as individuals and households who do not qualify under any of the populations above but meet ONE of the following criteria:

 

            (1) Other Families Requiring Services or Housing Assistance to Prevent Homelessness   is defined as households (i.e., individuals and families) who have previously been qualified as “homeless” as defined in 24 CFR 91.5, are currently housed due to temporary or emergency assistance, including financial assistance, services, temporary rental assistance or some type of other assistance to allow the household to be housed, and who need additional housing assistance or supportive services to avoid a return to homelessness.

 

           

            (2) At Greatest Risk of Housing Instability is defined as household who meets either paragraph (i) or (ii) below:

 

                        (i) has annual income that is less than or equal to 30% of the area median                                     income, as determined by HUD and is experiencing severe cost burden (i.e., is paying more than 50% of monthly household income toward housing costs);

 

                        (ii) has annual income that is less than or equal to 50% of the area median                                    income, as determined by HUD, AND meets one of the following conditions from paragraph (iii) of the “At risk of homelessness” definition established at 24 CFR 91.5:

                                    (A)Has moved because of economic reasons two or more times during                                          the 60 days immediately preceding the application for homelessness                                             prevention assistance;

                                    (B) Is living in the home of another because of economic hardship;

                                    (C)Has been notified in writing that their right to occupy their current                                            housing or living situation will be terminated within 21 days after the  date of application for assistance;

                                    (D) Lives in a hotel or motel and the cost of the hotel or motel stay is not                                      paid by charitable organizations or by Federal, State, or local government                                 programs for low-income individuals;

                                    (E) Lives in a single-room occupancy or efficiency apartment unit in which                                     there reside more than two persons or lives in a larger housing unit in  which there reside more than 1.5 persons reside per room, as defined by the U.S. Census Bureau;

                                    (F) Is exiting a publicly funded institution, or system of care (such as a                                            health-care facility, a mental health facility, foster care or other youth                                           facility, or correction program or institution); or

                                    (G) Otherwise lives in housing that has characteristics associated with                                           instability and an increased risk of homelessness, as identified in the                                             recipient's approved consolidated plan

 

 

 

Veterans and Families that include a Veteran Family Member that meet the criteria for one of the qualifying populations described above are eligible to receive HOME-ARP assistance.

 

 

If you have any questions regarding any of the Program Guidelines, or need language or other assistance, including translation and/or oral interpretation services, please email LIHP at BrookhavenARP@lihp.org before applying.


Si tiene alguna pregunta con respecto a cualquiera de las Pautas del Programa, o necesita asistencia lingüística o de otro tipo, incluidos servicios de traducción y/o interpretación oral, por favor envíe un correo electrónico a LIHP a BrookhavenARP@lihp.org antes de presentar la solicitud.


FUNDING IS LIMITED. ALL AWARDS ARE SUBJECT TO THE AVAILABILITY OF FUNDS.


A REQUEST FOR ASSISTANCE DOES NOT GUARANTEE AN AWARD OR THE PAYMENT OF THE AMOUNT REQUESTED.  A REQUEST FOR ASSISTANCE MAY BE AMENDED, ADJUSTED OR EVEN DENIED, WITHOUT NOTICE, BASED UPON AVAILABLE FUNDING.


Applicant Information













BY PROVIDING YOUR EMAIL ADDRESS, YOU EXPRESSLY CONFIRM THAT ALL NOTICES TO YOU PURSUANT TO THIS PROGRAM MAY BE SENT TO YOU VIA THIS EMAIL AND SHALL BE DEEMED RECEIVED BY YOU ON THE DATE OF THE TRANSMISSION BY LIHP.

Each applicant must be either a U.S. Citizen or a Qualified Alien (as defined at 8 USC 1641).



Demographic Information
The following information is for HUD monitoring purposes only and is required.  Your answer will not, in any way, impact your eligibility for the program.



Qualifying Population (Please check only one):
























Rental Assistance Requested

YOU CANNOT RECEIVE BOTH ARREARS AND PROSPECTIVE RENT/SECURITY DEPOSIT ASSISTANCE.

YOU MUST CHOOSE ONE OR THE OTHER.




STOP HERE.
It appears you are not qualified for this program.
Prospective unit must be located in the Town of Brookhaven to qualify.







Household Member #1







Household Member #2







Household Member #3







Household Member #4







Household Member #5







Household Member #6







OTHER PROGRAM PARTICIPATION

Document Upload

.PDF FORMAT DOCUMENTS ARE PREFERRED!
DOCUMENTS WILL NOT BE ACCEPTED VIA EMAIL!

Only use this secure form for sending documents.

**IMPORTANT - WHEN NAMING YOUR FILES FOR UPLOAD, DO NOT USE ANY SPECIAL CHARACTERS, USE LETTERS AND NUMBERS ONLY.**
BROOKHAVEN HOME ARP DOCUMENT UPLOADS:


DUPLICATION OF BENEFITS AGREEMENT AND SUBROGATION:


This Certification is necessary to assist with determining that assistance received from the Program does not duplicate or overlap with assistance received from other sources and the total amount of assistance does not exceed the amount of need in connection with the assistance awarded pursuant to the application submitted for the Program. Therefore, to be considered for the Program and in consideration of payments that may be received pursuant to the Program, the undersigned states, certifies and agrees as follows:


 1)      No other funds have been received or awarded for the assistance for the tenant/unit. If the undersigned has been, or is awarded or receives any funding for assistance that provides rental assistance for the tenant/unit, the undersigned will immediately advise LIHP in writing. Such amounts, if determined to be a duplication of benefits, will reduce the award that may be payable under the Program and, if disbursed, will be re-paid by the undersigned.  The obligation to re-pay any duplication of benefits is an on-going obligation.

NOTE:  IF THE HOUSEHOLD RECEIVES AN ADJUSTMENT OF THE HOUSEHOLD’S TENANT PORTION SUCH THAT THE PUBLIC HOUSING AUTHORITY/AGENCY OR ENTITY PROVIDING THE SUBSIDY COVERS THE TENANT PORTION BEING PAID PURSUANT TO THIS PROGRAM, THEN SUCH WILL BE A DUPLICATION OF BENEFITS THAT IS REQUIRED TO BE REPAID.

  

2)      The undersigned hereby assigns to the Town, or its agents, and HUD all of the undersigned’s future rights to reimbursement and all payments received from any grant, subsidized loan, public assistance payment, voucher payment or reassessment, or assistance under any assistance programs that are determined in the sole discretion of the Town and/or LIHP or HUD to be a duplication of benefits.


3)      The undersigned shall cooperate with the Town, or its agents, and/or HUD and such cooperation shall include, but shall not be limited to, executing and delivering such additional documentation as may be requested to further and better assign to the Town, or its agents, and/or HUD any amounts paid under the Program that are determined to be a duplication of benefits or in connection with the collection or enforcement thereof.


4)      Each of the undersigned explicitly allows the Town, or its agents, HUD, or any agency of the federal government, to request of any agency or organization with which the undersigned has applied for or is receiving funds, any information determined to be reasonably necessary to monitor/enforce its interest in the rights assigned to it under this Agreement and hereby give consent to such agency/organization to release said information to the Town or its agents, HUD, or any agency of the federal government.


5) The undersigned shall defend, indemnify, and hold harmless, LIHP, the Town, HUD, the federal government, and each of their officers, directors, members, employees, agents, and affiliates, from and against any and all losses, claims, judgements, assessments, charges, liens or other costs and expenses, including without limitation reasonable attorneys’ fees, arising out of or connected with any duplication of benefits or the collection or enforcement thereof.


6)  If unemployment benefits, federal or state stimulus payments, Paycheck Protection Program funds, or other assistance were/are being received for general, non-specific purposes, or for a different purpose, you certify that the benefits were/are utilized for other necessary items and were/are not available to pay the assistance needed pursuant to the Program.


7)  The undersigned agrees that LIHP and the Town will rely on the foregoing in its assessment of eligibility and determination of award and the representations and agreements set forth herein shall survive the submission of the Application or any award.


ADDITIONAL TERMS:


1)   If approved for an award, tenants, landlord and Town must execute a Rental Assistance Agreement and tenant and landlord must executed a Lease Addendum in accordance with HUD requirements including the Violence Against Women’s Act.in substantially the form attached hereto. By accepting funds under the Program, if eligible, the undersigned agrees that such funds will be paid by the Town directly to the owner of record of the premises as set forth in the Town/municipal records to the address provided by the landlord.


 2)   As a condition of review for eligibility, the undersigned shall permit LIHP, the Town and/or their agents, to inspect the premises for purposes of confirming compliance with Housing Quality Standards required by HUD and Lead Based Paint regulations, if applicable, prior to any determination of eligibility.  The undersigned acknowledges that If the unit fails inspection, landlord must complete the required repairs including lead-based paint clearance, at landlord’s sole expense, within thirty (30) days of determination, otherwise the unit will be ineligible for the Program and the undersigned will be removed from the waitlist with no right of appeal.


DISCLAIMERS:

The submission of documentation does not constitute acceptance, approval of qualification criteria, or a guarantee of a Program award. Please consult the Program Guidelines for all the Program requirements


PROGRAM GUIDELINES:

By signing below, I agree to participate in the Program and confirm that I have read the Program Guidelines and agree to all the terms and conditions contained therein.


AUTHORIZATION AND CONSENT:

1) LIHP, its program partners, and/or the Town is hereby authorized and permitted to disclose and verify any and all information contained in my application and on other documents submitted for the Program, to or with any third party, including but not limited to the Town, HUD, any agency or representative of the U.S. government, any representative or agency of New York State, my landlord or property management company, any member of my household, any o LIHP’s program partners, or any municipal agency or other entity providing rental or utility assistance (a “Third Party”), as applicable, either during the process or as part of the ongoing Program compliance. Without limiting the foregoing, LIHP, its program partners, and/or the Town may share information regarding my application and Program award, if applicable, with any other Third Party and are authorized to obtain information on me from any such Third Party regarding my application with such Third Party and my eligibility or award from such Third Party for rental assistance.


2) The undersigned authorizes any such Third Party to provide to LIHP, its program partners, the Town, any agency or representative of the U.S. government, or any representative or agency of New York, any and all information and documentation that they may request, including but not limited to, information and documentation on rent, utilities, payment history, employment history and income; bank, money-market, and similar accounts balances, credit history, copies of income tax returns, and application, status and award information regarding any rental or utilities assistance.


3) A copy of this authorization may be accepted as an original.


FAIR HOUSING AND NON-DISCRIMINATION:

LIHP is committed to furthering and promoting fair housing, equal opportunity, and non-discrimination in compliance with all federal, state and local laws, including, but not limited to, the Fair Housing Act, as amended by the Housing for Older Americans Act, the Americans with Disabilities Act, the Civil Rights Act, and the New York State Human Rights Law.  LIHP will have staff available to assist and answer questions about eligibility requirements.  In furtherance of this policy, LIHP will not discriminate on the basis of race, creed, color, national or ethnic origin, sex, sexual orientation, gender identity, familial status, source of income, religion, disability, veterans’ status, age, or any other basis prohibited by law.


LIMITED ENGLISH PROFICIENCY AND ACCOMMODATIONS:

LIHP will take reasonable steps to ensure that persons with Limited English Proficiency (LEP) and persons, who need assistance or who have a limited ability to speak, read, or write English, will have meaningful access and an equal opportunity to participate in the Program.  Interpreters, translators or other assistance needed to comply with this policy shall be provided as reasonably necessary.

 

ATTESTATION/SELF-CERTIFICATION

Each of the undersigned, does hereby affirm and attest, under the penalties of perjury and law, that (1) all of the information and certifications provided herein are true, correct and complete; and (2) the undersigned is a member of a Qualifying Population as stated above.


VIOLATION OF FEDERAL LAW:

THE APPLICANT CERTIFIES THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT. THE INFORMATION PROVIDED IS SUBJECT TO VERIFICATION BY LIHP, THE MUNICIPALITY, PROGRAM PARTNERS AND/OR ANY AGENCY OF NEW YORK STATE OR THE U.S. GOVERNMENT. BY SUBMITTING AN APPLICATION AND SUPPORTING DOCUMENTS, THE APPLICANT ACKNOWLEDGES AND UNDERSTANDS THAT TITLE 18 OF THE UNITED STATES CODE SECTION 1001: (1) MAKES IT A VIOLATION OF FEDERAL LAW FOR A PERSON TO KNOWINGLY AND WILLFULLY (A) FALSIFY, CONCEAL, OR COVER-UP A MATERIAL FACT; (B) MAKE ANY MATERIALLY FALSE, FICTITIOUS, OR FRAUDULENT STATEMENT OR REPRESENTATION; OR (C) MAKE OR USE ANY FALSE WRITING OR DOCUMENT KNOWING IT CONTAINS A MATERIALLY FALSE, FICTITIOUS OR FRAUDULENT STATEMENT OR REPRESENTATION, TO ANY BRANCH OF THE UNITED STATES GOVERNMENT; AND (2) REQUIRES A FINE, IMPRISONMENT FOR NOT MORE THAN FIVE (5) YEARS, OR BOTH, WHICH MAY BE RULED A FELONY, FOR ANY VIOLATION OF SUCH SECTION.


IF ELECTRONIC SIGNATURE:

You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document.  You understand that by signing and submitting the record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all the parties may rely on same.  

Electronic Signatures
Applicant



You do not meet the program requirements and therefore can't submit the application