Skip to form

City of Aurora

donotreply@auroragov.org

15151 E Alameda Pkwy, Aurora, CO, 80012, US

303-739-7000

City of Aurora Rental Assistance Application 2021 - Emergency Rental Assistance Program (ERAP)

Documents to Upload

Current Lease Agreement (Move-in date must be prior to Covid related loss of income)

Identification for ALL household members (Photo ID for persons over 17, Birth certificate for persons under 18)

Proof of City of Aurora, Colorado Residence for all persons on lease (Driver’s License/State ID or Bill with name and address)

Proof of Income prior to lossing it due to Covid 

Proof of COVID-related financial loss (employer letter, email, notice from healthcare provider or child’s school/daycare ON LETTERHEAD with contact information for the person writing the letter)

Current Monthly Income for all household members, including Child Support, Benefits award letters, SSI, SSDI, Unemployment.

Landlord Ledger from date of move-in to current with balance owing (Must show charges and amounts paid)

You will need to have all your documents ready to submit at the end of the application or it will not send.  All questions with * must be answered.

Section One

Receipt Number

You will be provided with a Receipt Number upon submission.

Preferred Language

APPLICANT / HOUSEHOLD INFORMATION

County

Unincorporated Arapahoe County is not eligible for this rent assistance.

Is this household member disabled?

Are you a veteran?

Race (Check all that apply)

For the purposes of this application - "Hispanic or Latino" - is a person of Cuban, Mexican, Puerto Rican, South or Central America or other Spanish culture/origin, regardless of race.  The term, "Spanish origin", can also be used.

*This information is being collected to ensure compliance with demographic reporting requirements.

Are there people age of 17 and younger?

ELIGIBILITY INFORMATION:

Do you have a voucher for rent assistance?

Voucher Type

Have you contacted your Housing Authority to readjust your rent amount?

If you do not have a voucher CONTINUE.

Loss of income due to COVID-19 after March 11, 2020?

Loss of income NOT due to COVID (NOT ELIGIBLE FOR THIS RENT ASSISTANCE)

How did you hear about this rental Program?

Are you already working with one of the following agencies?

Is this your first time requesting rental assistance?

Have you submitted or plan to apply for rent assistance with any other agency?

Housing / Unit Type

Section Two

INCOME INFORMATION : Income includes: Wages, salaries and tips, alimony, child support, military income, part-time income, temporary income, TANF, Social Security, other benefits, other income for all household members.   List ALL household members and their incomes. Attach a separate sheet if you need more space, or the “Income Source” table provided and their incomes. Attach a separate sheet if you need more space or use the “income Source” table provided immediately below.

FOOD STAMPS ARE NOT CONSIDERED INCOME – do not list food stamps. STIMULOUS CHECK – is not considered income

If you are self-employed, provide your 2019 and 2020 Federal tax return (all pages) AND self-employment records for last 4 months. (This is a federal program and filing tax returns are required)

For each household member, enter first and last name and their monthly income below.

Enter name and monthly income

Add a new input

Section Three

OTHER ASSISTANCE RECEIVED:

Have you received any other COVID-related rental assistance? Do not include CARES ACT stimulus payment.

*ERA funds cannot be used to pay for eligible costs that have already been paid for, or will be paid for, by another Federal program, insurance, or other sources. If this occurs, the grantee must repay its ERA grant.

Section Four

Applicant Certification - Certify that all information in the application is true, to the best of your knowledge. By signing this application, the applicant authorizes the City of Aurora or any of its duly authorized representatives to verify the information contained herein.

I/We understand the information provided above is collected to determine if I/We are eligible to receive assistance under the City of Aurora Emergency Housing Assistance Program for households economically impacted by COVID- 19.

I/We hereby certify that providing false statements or information is grounds for termination of housing assistance and is punishable under federal law.

I/We authorize the City of Aurora Emergency Housing Assistance Program and any of its authorized representatives to verify all information provided in this application.

I/We understand that additional information will likely be required to move forward with this program.

I/We understand that I/We may be responsible to repay/return any duplicated benefits received in concert with this program or any of the other assistance received hereafter.

Please sign this application below certifying that you understand and agree that you may be responsible for repaying any other benefits that are determined to be duplicated of the assistance received from this program.

Application prepared by:

The date this application is completed

Date Picker

Notice: Due to the nature of this program, and to avoid additional unnecessary contact, a typed name on this form will constitute the legal equivalent of your signature for the purposes of this application.

Warning:

Under penalties of perjury, I/we certify that the information presented in this document is true and accurate to the best of my knowledge and belief. I/We further understand that providing false representations herein constitutes an act of fraud. False, misleading or incomplete information may result in my ineligibility to participate in this program or any other programs that will accept this document. Additionally, if I/we receive future funding for the same purpose of the any CDBG-CV funds received, I/we will agree to repay the assistance that was duplicated.

 

Warning: Any person who knowingly makes a false claim or statement to HUD may be subject to civil or criminal penalties under 18 U.S.C. 287, 1001 and 31 U.S.C. 3729.

Applicant Full Name

ELIGIBILITY RELEASE: It is required that you sign this form, which allows the City of Aurora to request information from Third Parties concerning your eligibility and participation in this program.

Information Covered: Inquiries may be made about items including:

Income (all sources including dependent income), Assets (all sources), Child Support, Rental Amount.

Instructions to Applicant: Your signature on this Eligibility Release, and the signatures of each member of your household who is 18 years of age or older, authorizes the city of Aurora or any of its duly authorized representatives to obtain information from a third party regarding your eligibility and continued participation in the Emergency Housing Assistance Program (COVID-19).

Privacy Act Notice Statement: The City of Aurora requires the collection of the information listed in this form to determine an applicant’s eligibility for the Program. This information will be used to establish the level of benefits for which the applicant is eligible and to verify the accuracy of the information furnished. information received from an applicant or as a result of verifying the applicant’s eligibility may be released to appropriate Federal, State, and Local government and local agencies, or when relevant, to civil, criminal, or regulatory investigators, and to prosecutors, Failure to provide any information may result in delay or rejection of your eligibility approval. Subrecipient is authorized to ask for this information under the National Affordable Housing Act of 1990.

NOTE: THIS GENERAL CONSENT MAY NOT BE USED TO REQUEST A COPY OF A TAX RETURN.

Applicant’s Authorization:

I authorize the above-named Nonprofit, State or Local Government or Vendor to obtain information about me and my household that is pertinent to determining my eligibility for participation in the Program, I acknowledge that:

  1. A photocopy of this form is valid as the original; AND
  2. My printed name will act in lieu of a written signature for the purposes of this form: AND
  3. I have the right to review information received using this form; AND
  4. I have the right to a copy of information provided to the Subrecipient and to request correction of any information I believe to be inaccurate

WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government.

Electronic Signature of Head of Household:

Choose how to sign

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Application Signed by Agency

Documents to Upload

If the application isn’t allowing you to upload, please contact

COA-Rentassist@auroragov.org

 

Current Lease Agreement (Move-in date must be prior to Covid related loss of income)

Identification for ALL household members (Photo ID for persons over 17, Birth certificate for persons under 18)

Proof of City of Aurora, Colorado Residence for all persons on lease (Driver’s License/State ID or Utility Bill with name and address)

Proof of income prior to loss due to Covid 

Proof of COVID-related financial loss (employer letter, email, notice from healthcare provider or child’s school/daycare ON LETTERHEAD with contact information for the person writing the letter)

Current Monthly Income from all persons in the household, including Child Support, Benefit Award Letters, SSI, SSDI, Unemployment.

Landlord Ledger from date of move-in to current with balance owing (Must show charges and amounts paid)

Upload current Lease Agreement (Move-in date must be prior to Covid related loss of income)

Upload identification for ALL household members (Photo ID for persons over 17, Birth certificate for persons under 18)

Upload proof of City of Aurora, Colorado Residence for all persons on lease (Driver’s License/State ID or Utility Bill with name and address)

Upload Proof of Income prior to losing it due to Covid

Upload proof of COVID-related financial loss (employer letter, email, notice from healthcare provider or child’s school/daycare ON LETTERHEAD with contact information for the person writing the letter)

Upload current Monthly Income, including any child support, benefit award letters, SSI, SSDI, Unemployment (At least 2 consecutive paystubs from each person’s employer)

Upload landlord Ledger from date of move-in to current with balance owing (Must show charges and amounts paid)