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AEY Housing - Hardship Form

Resident Information:

Name:

Date:

Address:

Reason for Inability to Pay Rent:

Please provide a detailed explanation of the circumstances preventing you from paying your rent at Redemption Housing. Include any relevant information about recent changes in your financial situation or unforeseen challenges.

Employment Status:

Are you currently employed?

If not employed, please explain the reason:

Job Search Efforts:

If you are currently unemployed, please provide the following information regarding your job search efforts for the past week:

1. How many jobs have you applied to this week?
2. Can you provide proof of job applications?

Family Support:

Do you have any available support from family members who could assist you in paying your rent?

If you answered "Yes," are you willing to call your family members with a staff member present to discuss your current financial situation and demonstrate their inability to help you?

Understanding of Consequences:

By signing this form, you acknowledge and understand that the Redemption Housing program allows a maximum of six hardship forms. If you exceed this limit, it may result in your discharge from the program.

I understand that exceeding the maximum of six hardship forms may result in my discharge from the Redemption Housing program.

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Your legal name

Your email address

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Timestamp

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August 27, 2023 3:06 pm CDT

AEY Housing - Hardship Form Uploaded by Adam Lundquist - aeyhousing@gmail.com IP 24.152.20.247