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NH Department of Health and Human Services DHHS Division of Family Assistance DFA RENTAL VERIFICATION REQUEST DFA Form 775 12/13 To be completed by the landlord or Housing Authority if subsidized. TO FROM Centralized Scanning Unit P. House etc. Mobile home lot HUD 236 No Subsidy Other Specify Rent amount charged to tenant How often Weekly This amount has been charged since Twice per month Every two weeks Signature and Title of Landlord Manager or Housing Official Monthly Date Print Name of Landlord Manager or Housing Official Address Telephone PLEASE SEE INSTRUCTIONS ON BACK DFA SR 13-03 4YC How To Complete This Form This form is used by the NH Department of Health Human Services to collect rental verification information. Please complete the entire form beginning with the section titled PLEASE COMPLETE THE FOLLOWING INFORMATION and return it by the date requested in the first section. Thank you. O. Box 181 Concord NH 03301 Tenant s name Tenant s mailing address Street Apt City State Z....

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How to fill out the Dfa Form 775 online

This guide provides clear and supportive instructions on completing the Dfa Form 775 online. The form is essential for landlords or housing authorities to submit rental verification information required by the NH Department of Health and Human Services.

Follow the steps to complete the Dfa Form 775 effectively.

  1. Press the ‘Get Form’ button to access the document and open it in the online editor.
  2. Fill in the name(s) of the person(s) responsible for paying the rent, along with the street address and apartment number of the rental unit.
  3. Indicate the date occupancy began, the number of adults, and the number of children living in the rental unit.
  4. Specify whether the rent is current and provide the amount of arrearage if the rent is not current.
  5. Detail what is included in the rent, such as heat or utilities.
  6. If applicable, complete the subsidized housing section by selecting the type of subsidized housing and entering the gross and net family contributions.
  7. For non-subsidized housing, select the type of accommodation and provide the amount charged for rent and the frequency of this charge.
  8. Sign and date the form. Make sure to print your name, address and telephone number.
  9. Finally, return the completed form to the Central Scanning Unit at the address provided in the first section.

Please complete your documents online to ensure a smooth and efficient process.

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Contact support

To get help in New Hampshire, start by contacting local agencies or visiting the NH Easy Gateway. They offer resources for health, financial, and housing assistance. Many state programs are in place to support residents, and by utilizing forms like Dfa Form 775, you can streamline your request for assistance.

Filling out a shared shelter form in NH involves providing details about your living arrangement, including the number of occupants and the length of your stay. Be sure to provide accurate information about household income and expenses. If you encounter any challenges, consider using tools like Dfa Form 775 to help guide you through the completion process.

To apply for NH state health insurance, start by visiting the NH Easy Gateway. You will fill out an application that requires personal and financial information. It's essential to provide accurate details to ensure correct enrollment. Remember, Dfa Form 775 may also be necessary during this process to validate certain information.

When applying through NH Easy, you will need various documents such as proof of income, identification, and relevant health information. These documents help verify your eligibility for assistance programs. Additionally, if you are filling out certain forms, such as Dfa Form 775, make sure to refer to the instructions for specific documentation requirements.

NH Easy Gateway provides users with a simplified platform to access important resources, including health and financial assistance. It ensures a streamlined application process, saving users time and effort. With this gateway, you can easily manage your benefits and find necessary forms, like Dfa Form 775, ensuring that you meet state requirements effectively.

Typically, the rental verification form is completed by landlords or property managers on behalf of the tenant. Sometimes, the tenant may also need to provide relevant information. By sharing past rental experiences and payment histories, the form aids in establishing creditworthiness. Consider using Dfa Form 775 for added clarity and organization.

A rental verification is a document that confirms a tenant’s rental history and payment behaviors. It is often required by landlords or property management companies during the application process. To complete this form accurately, ensure that you gather all necessary details about past leases, payment records, and rental durations. Utilizing Dfa Form 775 can help streamline this verification process.

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