Home > EHSAP Training Documents and Power Points, ESHAP Program Documents, HCV Home to Stay > Home To Stay HCV Application Documents Updated June 2017

Home To Stay HCV Application Documents Updated June 2017

August 1, 2014

Form – General Authorization of Release ME RELAYThe various forms needed to complete an application for the Home To Stay HCV. These are program specific to ‘Home To Stay HCV’.  Staff and providers involved with Home To Stay HCV have had training on the forms and their use.

HTS Checklist 2017  (updated 6/8/2017)

HUD What you should Know about EIV – with signature block Feb 2010 Updated version 8/1/2014

HCV 2017 Zero Income Form (updated 6/8/2017)

Form – Consent to Screen for Criminal Activity 8.5 x 11-3 Updated version 9/24/2015

Form – DECLARATION OF SECTION 214 STATUS Updated version 8/1/2014

Form – General Authorization of Release ME RELAY Updated Version 8/30/2017

Form – HIPAA Release for MaineHousing 9-17-14  Updated version 9/24/2015

HUD 9886 Authrz to Release Information 1-31-14with MH address Updated Version 8/1/2014

HUD 52675 Debts Owed to PHA and Termination 4-30-13 Updated version 8/1/2014

HUD 92006 Supplement to Application Updated version 8/1/2014

Form- DV Lease Addendum New Form 8/1/2014

Form – Verification of Employment ME RELAY New Form 8/1/2014

Form – Verification of Disability Status ME RELAY  New Form 8/1/2014

2016 Application Personal Declaration  (New 5/11/2016)

Form – DHHS Authorization-Release   (New 8/31/2017)

Documents for navigators under the HCV Home to Stay program

Add Member check list


Navigator Role for HCV

Navigator Flow Chart


Income Description


Bedroom Allocation Cohead Other Adult


HCV HTS Briefing Documents


A- RA HOUSEHOLD Request & Authorz to Verify

Family Certification of Briefing HTS

C- RA Fair Housing Information

FSS Restart Flyer

HUD 903.1 Are You a Victim of Housing Discrimination 7-2001

HUD 52614a Tenancy Addendum 7-2015

HUD A Good Place to Live Brochure

HUD-1141 Is Fraud Worth It

Fraud & Misrepresentation – TNT

Low Poverty Info

Protect Family From Lead

Protecting Tenants at Foreclosure Act

Record of Search for Housing

VAWA Notice

HCV Landlord packet 1-2016



2016 Application Personal Declaration