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West TN Homeless Hotline
1-866-307-5469

Tennessee Homeless Solutions

ESG Forms

Rapid Rehousing

 
The following ESG forms have been approved by the West TN CoC Board and THDA:

ESG Program Policy and Procedures 2019-2020

EXAMPLE--Grievance and Termination Policy

  • 1. Verification of Homelessness-RRH Only
  • 2a Verification of At Risk Homelessness-Prevention Only
  • 2b Staff Certification
  • 3. Resource Exhaustion Verification
  • 4. Income and Asset Calculation Worksheet
  • 5. ESG Housing Barriers Levels 1-4
  • 6. Housing Stabilization Initial Action Plan
  • 7. Utility Allowance Worksheet
  • 8. Rent Reasonable Certification
  • 9. Habitability Inspection Checklist
  • 10. Lead Based Paint Visual Assessment
  • 11. Inspection Deficiencies Notice--If applicable
  • 12. Rental Assistance Agreement between Landlord and Agency

Other Forms if needed:

  • RRH Checklist
  • Prevention Checklist
  • EXAMPLE--Statement of Understanding and Agreement

  • LBP Information Disclosure
  • LBP Owner Certification
  • LBP Risk Assessment
  • Monthly Budget Form
  • Self Certification of Homelessness
  • Self Declaration of Income
  • Third Party Verification of Income
Tennessee Homeless Solutions
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