HOUSING COUNSELING SERVICES

DC FLEX FUND PROGRAM

APPLICATION PACKAGE

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Flex Fund Information Summary

The Housing Counseling Services’ (HCS) Veterans Flex Fund offers financial assistance to District of Columbia (D.C.) Veterans to resolve or prevent homelessness.  The Program is designed to be low barrier, flexible and does not require intensive case management. Veterans may apply directly or through community case managers/social workers. 


The overall goal of the Flex Fund is to support efforts to rehouse homeless Veterans and to prevent recurring homelessness by offering limited, realistic and wholistic financial supports, where the necessary financial resources are unavailable or more difficult to access through other established programs.  Flex Funds are limited and while all applications will be considered, full funding may not be approved for all specific requests.  HCS will consider applications that present a good case for financial assistance needed for rehousing or housing stability.  The maximum financial assistance available through Flex Funds is $5,000 per household (request for higher levels of financial assistance may be considered on a case-by-case basis).   


Limited Flex Fund financial assistance may include supports to:

  • Resolve Homelessness: security deposit, application fees, first month rent, move-in fees, utility deposits, essential supplies/furnishings, moving costs, ID fees, etc.
  • Prevent Homelessness:  delinquent rent, delinquent mortgage payments, delinquent utilities, basic/essential repairs, essential supplies, support for income stability such as transportation, car repairs, employment interview supports, etc.

Basic eligibility for the Veterans Flex Funds Program include:

  • The Veteran must have served active duty in the U.S. military.
  • The Veteran must live in the District of Columbia.
  • The Veteran must be homeless or at risk of homelessness.
  • The requested financial assistance must be clearly connected to preventing or resolving homelessness.
A completed Flex Fund application package will consist of the following documents:
  • Completed HCS Flex Fund Application
  • Picture ID for Veteran applicant
  • Completed HMIS Release of Information (ROI) signed by Veteran applicant
  • Completed Authorization to Obtain Information form signed by Veteran applicant
  • Documentation of need that includes third party invoice, bill or statement for the expenses for which the Veteran is applying for assistance.  The document must demonstrate that the Veteran is the individual responsible for the expense.  If the expense is something that the Veteran must purchase, documentation of the cost of purchase.

Please be sure to include all required eligibility documentation and answer all questions on the application, as partial applications may be denied.  PLEASE NOTE:  HCS will verify information included in the application (for instance: veteran status, homelessness status, residency, risk of homelessness) through other sources.  If HCS staff are unable to confirm information provided in the application package, additional documentation may be requested.

The Flex Fund has limited funds and is NOT a program “by right”.  The Program targets and prioritizes Veterans who are currently homeless, Veterans who have been homeless in the last two years, and Veterans at risk for homelessness.  HCS encourages Veterans to apply for Flex Fund assistance and will offer prompt consideration of all requests. Upon review of the submitted application for financial assistance, HCS may determine that a full payment will be made, that a partial payment will be made and the applicant will be required to contribute towards their requested expense, that the applicant must first apply for resources from another program, that the request is beyond the scope of the Flex Fund, or that the applicant has sufficient financial resources to address the expense without Flex Fund assistance. HCS encourages Veterans to apply for Flex Fund assistance and will offer prompt consideration of all requests.


If you have further questions about the Flex Fund Program, please email flexfund@housingetc.org or call 202-667-7366.

Because you selected that you are not a Veteran who served active duty in the U.S. military, naval, or air service you are not eligible for this program and cannot move forward with this application.
Military Service Information





Case Manager Information







Veteran Applicant Details





If client does not have a social security number, please enter all zeroes


Veteran Mailing Address


Mailing Address





Veteran Current Address:





Contact Information


Please list an email if you have one.

Demographic Information 









Include the applicant and any other individuals residing in the household full time.
Veteran Applicant Income
Please enter all income sources for the primary applicant. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #1





Other Household Member #1 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #2





Other Household Member #2 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #3





Other Household Member #3 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #4





Other Household Member #4 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #5





Other Household Member #5 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #6





Other Household Member #6 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #7





Other Household Member #7 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #8





Other Household Member #8 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Other Household Member #9





Other Household Member #9 Income
Please enter all income sources for this household member. Click "add another income source" below this box to add another. If you have no income, just select the "Income Source Type" of "No Income" and enter Amount as $0.



Household Income and Assets


Veteran Housing Status 

Currently Homeless











Currently Housed, but at Risk for Homelessness or Unstably Housed










Homelessness Services Provider, Case Manager, or Social Worker




Flex Fund Financial Assistance Request 





Back Rent Assistance



Payment Details










Mortgage Delinquency Assistance



If more than one document, click "add another document".
Payment Details








Other Homeownership Expenses Assistance
If you have more than one Homeownership Expense assistance request, click "add another expense" to create a new record.









First Month's Rent and/or Security Deposit Assistance


Payment Details

If First Month's Rent and Security Deposit need to be paid separately, click "add another expense" below to add the second payment details.








Rental Application Fee/Holding Fee Assistance









Utility and Telephone Assistance
If you have more than one utility or phone assistance request, click "add another expense" to create a new record.


Utility Deposit Detail

Past Utility Due Detail

Payment Details








Moving Expenses Assistance
Payment Details
If you have more than one moving expense, click "add another expense" to create another record. 









A moving company must have a valid business license and comply with local insurance requirements
Essential Supplies/Furnishings Assistance
If you have more than one essential supply/furnishing expense, click "add another expense" to create another record. 









Transportation/Car Expenses Assistance

Car Related Expense Details

Payment Details
If you have more than one transportation or car repair expense, click "add another expense" to create another record. 









Storage Fees Assistance
Payment Details









Employment Support Assistance
If you have more than one employment support expense, click "add another expense" to create another record. 

Payment Details









Other Financial Assistance That Will Assist Applicant Stabilize Their Housing
If you have more than other expense, click "add another expense" to create another record. 

Payment Details









Disclosure and Consent Statements

To the best of my knowledge and belief, I certify that the foregoing information is true, complete and accurate. I understand that if I have provided any false information, this may result in the denial of this request for financial assistance under this program. I authorize Housing Counseling Services, Inc. (HCS) to contact individuals and/or agencies on behalf of this applicant to verify information related to this application.

           

I understand that annual audits will be conducted to verify HCS’ compliance with local, federal, and funding agency regulations.  I authorize HCS to allow the review of this application, including all verifications and documentation, by the HCS Organizational Auditor or Funding Agency Compliance Auditor/Monitor.  All Auditors/Monitors are prohibited from disclosing any personal client information to any source.  This authorization will remain in effect as long as an Organizational Auditor or Compliance Auditor/Monitor determines that the review of client files is necessary to complete federally mandated audits, reviews and report(s).

           

My consent shall terminate upon five (5) years from the date of my signing this document. 


Type name of person completing this form.