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Homeless Prevention Homeless Rapid Re-housing ☐ Government Issued Photo ID for all adults (age 18 and over) in household ☐ Government Issued Photo ID for all adults (age 18 and over) in household ☐ Birth certificate OR social security card for each minor (under age 18) in household. ☐ 3 months of income statements. If there is no income the household DOES NOT QUALIFY FOR ASSISTANCE ☐ Birth certificate OR social security card for each minor (under age 18) in household. ☐ 3 months of income statements. If there is no income the household DOES NOT QUALIFY FOR ASSISTANCE ☐ 3day Notice or Eviction Documentation. If none, the household DOES NOT QUALIFY FOR ASSISTANCE. ☐ 3day Notice or Eviction Documentation. If none, the household DOES NOT QUALIFY FOR ASSISTANCE. ☐ The household is at risk of being homeless but for HPRP assistance. ☐ Participant household shall have resided in the city of Palmdale for the 3-month period immediately preceding the application for HPRP assistance. ☐ Occupying housing in the City of Palmdale. ☐ Agreement with property manager/owner that they are willing to accept HPRP assistance on behalf of client. ☐ Confirmation that the property management has a valid business license. ☐ Confirmation that the property is currently enrolled in the residential rental unit inspection program. ☐ Unit will pass a Health & Safety Inspection ☐ The household has experienced a qualifying event that has resulted in their need for assistance. ☐ The household is at risk of being homeless but for HPRP assistance. ☐ Participant household shall have resided in the city of Palmdale for the 3-month period immediately preceding the application for HPRP assistance. ☐ Occupying new housing in the City of Palmdale. ☐ Agreement with property manager/owner that they are willing to accept HPRP assistance on behalf of client. ☐ Confirmation that the property management has a valid business license. ☐ Confirmation that the property is currently enrolled in the residential rental unit inspection program. ☐ Unit will pass a Health & Safety Inspection ☐ The household has experienced a qualifying event that has resulted in their need for assistance. ☐ Verification of Homelessness from third party. If none, the household DOES NOT QUALIFY HPRP (Homeless Prevention Rapid Re-housing) If you can check all of the boxes on either column and provide proper documentation, you may qualify for HPRP assistance. CALL [PHONE REDACTED] EXT:5296 leave your name and number.