Section 1 of 1 in this document

Ocean County ERAP COVID-19 Impact and Risk of Homelessness Attestation

Translate

IMPORTANT INFORMATION

Program assistance is available by calling 1-833-753-9671.
Call center hours are from 8 a.m. to 5 p.m., daily.

Inquiries can be addressed to Oceancountyerap@wittobriens.com.

Contact email to receive a copy of this document

Ocean County ERAP Application Number

How has the COVID-19 pandemic (since March 2020) affected your household's income or assets? Check all that apply.

Currently am or have been unemployed

Qualified for Unemployment benefits

Laid off or pause in work

Medically at-risk and unable to work

Caring for COVID-impacted household member

Loss of child or spousal support

Caring for children at home due to remote education or closed daycare

I/we did not experience a reduction in income

I attest that this information provided for COVID-19 pandemic impact is correct and complete to the best of my knowledge.

Have you or a member of your household experienced any of the following housing risks? Check all that apply for any household members over the age of 18.

Slept in an overcrowded residence therefore at an increased risk of exposure to COVID-19

Feared or felt unsafe due to domestic violence, sexual assault or stalking

Paid rent or utilities instead of meeting essential household needs (e.g., purchasing food, prescriptions, transportation)

Used high-interest lenders to pay for rent or utilities

Slept overnight in a place not meant for human habitation and/or in a temporary shelter or temporary residence

Lived in a place not meant for human habitation

Faced significantly higher utility or home heating costs that threaten housing stability

Received notice of eviction, or have an eviction court hearing

I/we did not experience housing risks

I attest that this information provided for risk of housing instability or homelessness is correct and complete to the best of my knowledge.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

Under penalty of perjury, I certify that the information presented in this certification is true and accurate to the best of my knowledge. I further understand that providing false representations constitutes an act of fraud. False, misleading, or incomplete information may result in the repayment of any funds received through the Ocean County Residential Emergency Rental Assistance Program and other remedies available under applicable law.

Ocean County ERAP COVID-19 Impact and Risk of Homelessness Attestation

Translate

Full Name

How has the COVID-19 pandemic (since March 2020) affected your household's income or assets? Check all that apply.

What significant expenses have you had due to the COVID-19 pandemic (since March 2020)? Check all that apply.

Have you or a member of your household experienced any of the following housing risks? Check all that apply for any household members over the age of 18.

Sign Here