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This form is designed for staff to request payments on behalf of households approved for Household Assistance or Moving Assistance under the HomeBASE program.
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How to fill out HomeBASE Household Assistance or Moving Assistance Request for Payment

01
Gather necessary documents, including identification and proof of income.
02
Obtain the HomeBASE Household Assistance or Moving Assistance Request for Payment form from your local agency.
03
Fill out the personal information section with your name, address, and contact details.
04
Provide details regarding your housing situation and the specific assistance being requested.
05
Attach any supporting documents required, such as lease agreements or eviction notices.
06
Review your application for accuracy and completeness.
07
Submit the completed form and supporting documents to the appropriate agency office.

Who needs HomeBASE Household Assistance or Moving Assistance Request for Payment?

01
Individuals or families experiencing homelessness or housing instability.
02
Residents facing eviction or displacement.
03
Those relocating to stable housing situations.
04
Low-income households needing assistance with moving costs.
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To be considered for HomeBASE a family must be determined eligible for Emergency Assistance (EA) by a DHCD Homeless Coordinator. Eligibility requires that a participant have an annual household income at or below 115% of the federal poverty level and a child under 21.
Have a gross income at or below 200% of the federal poverty level; 2. Be on Cash Assistance, if eligible; 3. Not qualify for any other rental assistance program; If you have any questions about CityFHEPS and your eligibility, you should talk to your housing specialist or case manager.
You may be eligible for Homebase services if you: Are at imminent risk of entering the New York City shelter system. Are low-income. Want to remain stably housed in your community.
The Affordable Housing Program designates 20% of the units in an Affordable Housing Project to be occupied by applicants who earn up to 60% of the Annual Median Income (AMI) which is currently set at $38,100 per year for an individual, and $54,360 for a family of four.
If you are eligible for HomeBASE, it can pay for: Monthly payments to help with rent for up to 2 years, for your own apartment, living with a host or co-sharing an apartment. First and last month's rent, security deposit, and broker's fee for a new apartment.
Homebase provides New Yorkers experiencing housing instability in the community with various homeless prevention services and aftercare services to families and individuals exiting NYC DHS shelter to permanent housing. Homebase locations are servicing clients either via phone or for in-person services.
: the place in which someone or something lives or operates. The company's home base is in New York. She returned to her home base after a long month of traveling. 2. baseball : the base that a runner must touch in order to score.
Identification for all adult each household member. Proof of income/employment for every working member of the household (recent paystubs dated within 30 days of HOMEBASE appointment) If you have an active public assistance- Cash Assistance (CA) case, please bring a CA Budget Letter/WMS printout (dated within 30 days).

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HomeBASE Household Assistance or Moving Assistance Request for Payment is a program designed to provide financial support to households at risk of homelessness or those needing assistance with moving to stable housing.
Households experiencing homelessness or those at imminent risk of becoming homeless, along with service providers or organizations assisting them, are required to file the request.
To fill out the request, applicants must complete the designated form with necessary personal and household information, details about the assistance needed, and any required documentation.
The purpose is to assist eligible households in obtaining necessary financial aid for moving expenses or other forms of household support to promote housing stability.
The request must include personal identification details, household composition, income information, the reason for assistance, and any other relevant financial documentation.
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