Get Ny Pas-106h 2014-2026

The NY PAS-106H is an essential intake form for individuals seeking Shelter Plus Care rental assistance. This guide provides a clear and supportive overview of how to complete the form effectively, ensuring that you provide all necessary information for a successful application.

Follow the steps to fill out the NY PAS-106H online:

1. Click ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Enter your full name in the designated field.
3. Provide the current date of completion and your date of birth to verify your identity.
4. Enter your Social Security number in the appropriate field.
5. Fill in the name of the referring agency and the contact person from that agency.
6. Include the name and contact number of your case manager for reference.
7. Input your current residence details, if applicable, along with alternative contact methods.
8. Describe your current living situation by checking the appropriate box that aligns with HUD’s definition of homelessness.
9. If applicable, indicate whether a Certificate of Homelessness has been completed and attached.
10. Answer whether the individual can be classified as chronically homeless and attach necessary documentation.
11. Specify the qualifying disability, if any, and confirm whether documentation from a qualified professional is attached.
12. List all household members, their names, dates of birth, ages, and Social Security numbers.
13. Complete the demographics section by indicating the total number of household members and their ethnic and racial backgrounds.
14. Check any special needs program qualifications that apply to the primary program participant.
15. Document total household monthly income from specified sources and check any relevant financial resources.
16. Provide details on bank accounts, including the type, bank name, and account amounts.
17. Read the asset declaration statement and certify that the listed assets are accurate.
18. Sign and date the application to affirm that all provided information is correct.
19. Ensure you have included all necessary documentation, such as a signed release of information, proof of identity, income verification, and disability documentation.

Complete your NY PAS-106H online to apply for Shelter Plus Care rental assistance today.