DMHAS CoC Rental Assistance Documents
The documents below have been provided by the CT Department of Mental Health and Addiction Services (DMHAS) and are required for use by all DMHAS CoC Rental Assistance projects.
- CT BOS Permanent Supportive Housing (PSH) Operations and Requirements Guide – PDF (2023.05.25)
- CoC Monitoring Tool & Guide – PDF (2022.12.14)
- Annual Recertification Notice – DOC
- Approval Letter Rental Assistance – DOC
- Brief Participant Needs Assessment – DOC
- CAN Referral and Acceptance Documentation – DOC (2022.09.26)
- CoC change in income sample payment letter – DOC
- CoC Rental Assistance Housing Certificate – DOC
- Contract Amendment – DOC (2023.05.16)
- Contract – Housing Assistance Payments (HAP) – PDF (effective 2023.04.03)
- Copy of Change Order – XLS
- Disabling Condition Verification Form – See https://www.ctbos.org/resources/ under Eligibility Tools
- DMHAS HIPAA RVS – PDF
- Federal Privacy Act Notice – DOC
- HMIS Release of Information – PDF (2022.05.25)
- HMIS Spanish ROI Updated: 11-8-18 – DOC
- Homeless Verification Form: See https://www.ctbos.org/resources/ under Eligibility Tools
- HQS Inspection form 52580A – PDF (2022.10.19)
- Lead Paint Booklet English – PDF
- Lead Paint Booklet Spanish – PDF
- Lease CoC Rental Assistance Program – DOC
- Lessor Lead Paint Disclosure – PDF
- Income Calculation Worksheet 9.22.20 – XLS
- New Admission Form – XLS (2023.04.03)
- No Income Verification – DOC
- Occupancy Continuation Form – DOC
- Owners Assurances – DOC
- Owners Authorization To Sign – DOC
- Partnership Agreement Form Letter – DOC
- Participant Bill of Rights – PDF (2023.03.23)
- Participant docs received sign off list – PDF
- Rental Assistance List of Advocates – DOC
- Recertification Payment Letter – DOC
- Rent Reasonableness Verification – DOC
- Request For Lease Approval – DOC
- Required Documents Checklist -PDF (2023.05.04)
- Termination from HEARTH Housing Form 9 24 12 – DOC
- Termination of HEARTH Housing Form – Spanish – DOC
- Termination Letter with Formal OOC Hearing Request – DOC
- Termination Letter with Informal Hearing Request(2) – DOC
- VAWA Lease Addendum – DOC
- Vendor Profile Form – PDF
- W-9 – PDF (2023.03.06)
- Warning Letter Generic Sample – DOC