Emergency Rent Assistance Program | Neighbor to Neighbor

Rent Assistance Pre-Screen - New Applicants

First Name(Required)

Last Name(Required)

Email Address(Required)

Phone Number(Required)

Are you a renter with a Larimer County lease?(Required)

Yes

Does your rental household earn less than 60% of the AMI?(Required)

Please review the Area Median Income information below. If your household income is higher than the amount listed next to the number of people in your household, your response is "No." If your income is less than that amount, your response is "Yes." (# of people in household): 60% AMI amount 1: $45,120 | 2: $51,480 | 3: $57,960 | 4: $64,380 | 5: $69,540 | 6: $74,700 |

Yes

Do you currently have documentation of an eviction notice or demand for compliance from your landlord?(Required)

This must be a legal document, not an email or a text message.

Yes

Can you provide third party documentation to verify your need for assistance is unforeseen and out of your control?(Required)

Yes

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Phone

This field is for validation purposes and should be left unchanged.