[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-281473-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-281473-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","emergency-solutions-grant-homelessness-certification-esg-eligibility-forms","EMERGENCY SOLUTIONS GRANT - HOMELESSNESS CERTIFICATION - ESG Eligibility Forms","","Emergency Solutions Grant (ESG) homelessness certification forms used to confirm eligibility for emergency shelter, rapid re-housing, and prevention services. The forms require household identifying information and date, then certify homelessness status based on selected categories. Categories cover literally homeless households, imminent risk of homelessness, and fleeing/attempting to flee domestic violence. 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Additional institution-exit evidence may apply depending on the pathway.",{"name":70,"@type":61,"acceptedAnswer":71},"What additional documentation is required for Category 2 (Imminent Risk of Homelessness)?",{"text":72,"@type":64},"In addition to one qualifying evidence item, the form requires certification that no subsequent residence has been identified and self-certification or other written documentation that the household lacks the resources and support networks needed to obtain permanent housing.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},281473,1790472425,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":33,"preview_page_count":4},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","EMERGENCY SOLUTIONS GRANT  \nHOMELESSNESS CERTIFICATION – EMERGENCY SHELTER  \nESG Household Name:   Date:    \nThis is to certify the above individual or household is currently homeless based on the category checked and required documentation.  \nCATEGORY 1: Literally Homeless  \n Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:  \n(i) Has a primary nighttime residence that is a public or private place not meant for human habitation; or  \n(ii) Is living in a publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state and local government programs) .  \nTo certify homeless status for the above, must provide documentation of one of the following:  \n Written observation by the outreach worker; or  \n Written referral by another housing or service provider; or  \n Certification by the individual or head of household seeking assistance stating that (s)he was living on the streets or in shelter (use self-certification form)  \n Individual or family who lacks a fixed, regular, and adequate nighttime residence, meaning:  \n(iii) Is exiting an institution where (s)he has resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution  \n(documentation must include one of the above forms of evidence AND one of the following) .  \n Discharge paperwork or written/oral referral; or  \n Written record of intake worker’s due diligence to obtain above evidence and certification by individual that they exited institution (use self-certification form)  \nCATEGORY 2: Imminent Risk of Homelessness  \n Individual or family who will imminently lose their primary nighttime residence, provided that:  \n(i) Residence will be lost within 14 days of the date of application for homeless assistance;  \n(ii) No subsequent residence has been identified; and  \n(iii) The individual or family lacks the resources or support networks needed to obtain other permanent housing.  \nDocumentation must include one of the following:  \n A court order resulting from an eviction action notifying the individual or family that they must leave; or  \n For individual and families leaving a hotel or motel—evidence that they lack the financial resources to stay (use self-certification form); or  \n An oral statement that residence will be lost within 14 days of the date of application for homeless assistance that if verified by an intake worker or  \n If the intake worker is unable to verify the oral statement, must document due diligence in attempting to obtain verification and obtain written certification by the individual or head of household seeking assistance (use self-certification form)  \nIn addition to one of the above, documentation must include ALL of the following:  \n Certification that no subsequent residence has been identified (use self-certification form); AND  \n Self-certification or other written documentation that the individual lack the financial resources and support necessary to obtain permanent housing (use self-certification form) .  \nCATEGORY 4: Fleeing/Attempting to Flee Domestic Violence  \n Any individual or family who:  \n(i) Is fleeing, or is attempting to flee, domestic violence;  \n(ii) Has no other residence; and  \n(iii) Lacks the resources or support networks to obtain other permanent housing Documentation required:  \nFor victim service providers:  \n An oral statement by the individual or head of household seeking assistance which states: they are fleeing; they have no subsequent residence; and they lack resources. Statement must be documented by a self-certification (use self-certification form) or a certification by the intake worker.  \nFor non-victim service provider (must document all ofthe following):  \n Oral statement by the individual or head of household seeking assista","cbCaikAF1VR9K2Ak","https://ap.wps.com/l/cbCaikAF1VR9K2Ak","pdf",274280,"English","# Homelessness Certification (Emergency Shelter)\n## Category 1: Literally Homeless\n## Category 2: Imminent Risk of Homelessness\n## Category 4: Fleeing/Attempting to Flee Domestic Violence\n# Homelessness Certification (Rapid Re-Housing/Prevention)\n## Category 1: Literally Homeless (Rapid Re-housing Assistance Only)","[{\"question\":\"What does the ESG homelessness certification confirm?\",\"answer\":\"It certifies that the individual or household is currently homeless based on the selected category and the documentation requirements listed on the form.\"},{\"question\":\"What evidence is required for Category 1 (Literally Homeless)?\",\"answer\":\"Documentation must include one approved form of evidence such as written observation by an outreach worker, a written referral by another provider, or self-certification stating the household is living on the streets or in shelter. Additional institution-exit evidence may apply depending on the pathway.\"},{\"question\":\"What additional documentation is required for Category 2 (Imminent Risk of Homelessness)?\",\"answer\":\"In addition to one qualifying evidence item, the form requires certification that no subsequent residence has been identified and self-certification or other written documentation that the household lacks the resources and support networks needed to obtain permanent housing.\"}]","EMERGENCY SOLUTIONS GRANT - HOMELESSNESS CERTIFICATION - ESG Eligibility Forms | PDF",1789566351]