1. Policy Statement
Family Promise of Puget Sound provides vital assistance to individuals and families experiencing homelessness. To ensure that our services reach those most in need and to comply with federal and state guidelines, we require accurate and complete information from all applicants. This document outlines the certification process for your eligibility and the understanding that the information you provide is true and subject to verification.
2. Your Certification and Acknowledgment
By signing this document, you certify and acknowledge the following:
* Accuracy of Information: All information you provide to Family Promise of Puget Sound, including details about your household and housing situation, is true, correct, and complete to the best of your knowledge.
* Purpose of Information: You understand that the information provided will be used by Family Promise of Puget Sound to determine your eligibility for our programs and the type and amount of assistance you may receive.
* Verification: You understand that this information is subject to verification by Family Promise of Puget Sound staff. We may need to confirm details with other agencies or sources as part of our eligibility process.
* Consequences of Falsification: You understand that falsification (providing false or misleading information) of this information may be grounds for immediate termination from the program and could result in prosecution under applicable federal and state laws.
3. Certification of Homeless Status
I certify that my household meets the definition of “homeless” as an individual or family under one of the following categories, consistent with federal guidelines (e.g., HUD definition):
* Residing in a Place Not Meant for Human Habitation: My household is currently residing in a place not meant for human habitation, such as streets, cars, parks, sidewalks, abandoned buildings, or other similar locations.
* Residing in Homeless Shelters or Treatment Programs: My household is currently residing in a homeless shelter or a treatment program designed to provide temporary housing.
* Imminent Discharge from Institution/Jail/Prison: I (or a household member) am being discharged within one week from an institution (e.g., hospital, mental health facility) or a jail/prison, where I have been a resident for 90 days or less, and no subsequent residence has been identified, and I lack the resources and support networks needed to obtain housing.
* Imminent Loss of Primary Nighttime Residence: My household will imminently lose our primary nighttime residence within 14 days, AND no subsequent residence has been identified, AND we lack the resources and support networks needed to obtain housing.
* Unaccompanied Youth or Families with Children (Specific Federal Statutes): My household, as an unaccompanied youth under 25 years of age, or a family with children and youth, does not otherwise qualify as homeless under the direct HUD definition above, but meets the definition of homeless under other listed federal statutes, AND has not had a lease, ownership interest, or occupancy agreement in permanent housing during the 60 days prior to this homeless assistance application; AND has experienced persistent instability as measured by two or more moves during the preceding 60 days; AND can be expected to continue in such status for an extended period of time due to special needs or barriers.
* Fleeing Domestic Violence: My household is fleeing, or attempting to flee, a domestic violence, dating violence, sexual assault, stalking, or other dangerous housing situation, AND no subsequent residence has been identified, AND we lack the resources and support networks needed to obtain housing.