[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-306772-105":53,"doc-detail-306772-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","emergency-rental-assistance-program-self-attestation-form-instructions","Emergency Rental Assistance Program - Self-Attestation Form - Instructions","","Instructions for completing the Emergency Rental Assistance Program Self-Attestation Form, providing a written statement to support eligibility when required documentation is unavailable. Applicants must select applicable criteria, including household income, financial impact, housing impact, or residence, and complete the household member income table and narrative attestations. The form explains two income determination methods, allowable income sources, and COVID-19 impact and housing risk descriptions. A signed certification, uploaded with the online application, verifies accuracy and may affect processing or assistance limits.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/emergency-rental-assistance-program-self-attestation-form-instructions/306772/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/emergency-rental-assistance-program-self-attestation-form-instructions/306772.png","ImageObject",442,249,{"name":88,"@type":89},"Guten tag","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-24","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",9,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What can applicants self-attest when they lack supporting documents?","Question",{"text":109,"@type":110},"Applicants may self-attest eligibility based on one or more criteria: household income, financial impact, housing impact, and residence. The form instructs completing only the applicable sections where documentation cannot be provided.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How is household income determined for eligibility purposes?",{"text":114,"@type":110},"The form provides two methods: using 2020 annual income based on IRS Form 1040 AGI, or using recent annual income calculated from the last two months multiplied by 6. If the recent method is used, income must be recertified every 3 months for extensions.",{"name":116,"@type":107,"acceptedAnswer":117},"What does the applicant certification require and what are the consequences?",{"text":118,"@type":110},"The applicant must sign the certification declaring the statement is true and correct under penalty of perjury and agree to provide additional information on request. 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If this method is used to determine income eligibility, applicants will need to recertify their income every 3 months for any award extensions applied for by the applicant.  \nSources of income may include: salary, wage, tips, commissions, business income, interest, dividend, social security benefit, annuities, insurance, Social Security, annuities, insurance policies, retirement funds, pensions, disability or death benefits, unemployment and disability compensation, worker's compensation and severance pay, and Welfare assistance payments.  \nWRITTEN ATTESTATION OF LACK OF INCOME DOCUMENTATION  \nPlease detail the circumstances that do not permit the applicant to complete the 1040 Tax Return and/or provide the documents necessary  \nto complete an income eligibility review:  \nWRITTEN ATTESTATION OF COVID-19 FINANCIAL IMPACT  \nPlease describe how you or one or more individuals within the household has experienced a reduction in household income, incurred significant costs, or experienced other financial hardship due, directly or indirectly, to the COVID-19 outbreak:  \nWRITTEN ATTESTATION OF COVID-19 HOUSING IMPACT  \nPlease describe how you or one or more individuals within the household is currently at risk of experiencing homelessness or housing instability due to unsafe or unhealthy living conditions or other evidence of risk.;  \nWRITTEN ATTESTATION OF RESIDENCE  \nPlease provide information about your rental unit and landlord  \n\n| Rental Unit Address |  |\n| --- | --- |\n| Address 2 |  |\n| City |  |\n| Zip Code |  |\n| Name of Landlord |  |\n| Landlord Email Address |  |\n| Landlord Phone Number |  |\n| Monthly Rent Owed |  |","cbCail49z2aqZiMa","https://ap.wps.com/l/cbCail49z2aqZiMa","pdf",240521,7,"English","# Instructions\n## Eligibility Criteria\n## Household Information\n## Income Determination Methods\n## Written Attestations\n## Residence Details\n## Certification and Warning","[{\"question\":\"What can applicants self-attest when they lack supporting documents?\",\"answer\":\"Applicants may self-attest eligibility based on one or more criteria: household income, financial impact, housing impact, and residence. The form instructs completing only the applicable sections where documentation cannot be provided.\"},{\"question\":\"How is household income determined for eligibility purposes?\",\"answer\":\"The form provides two methods: using 2020 annual income based on IRS Form 1040 AGI, or using recent annual income calculated from the last two months multiplied by 6. If the recent method is used, income must be recertified every 3 months for extensions.\"},{\"question\":\"What does the applicant certification require and what are the consequences?\",\"answer\":\"The applicant must sign the certification declaring the statement is true and correct under penalty of perjury and agree to provide additional information on request. The form warns that provided information is subject to verification and that false or fraudulent statements can be considered felonies with assistance potentially terminated.\"}]","Emergency Rental Assistance Program - Self-Attestation Form - Instructions | PDF",1789840911]