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Homelessness Self Certification Statement
Instructions: This form may be used when an individual applying to a program lacks
connections with service providers to complete a third party verification
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How to fill out self certification of homelessness
How to fill out homelessness self certification statement
01
Obtain the homelessness self-certification statement form from the appropriate authority or agency.
02
Read the instructions carefully to understand the requirements and purpose of the form.
03
Fill in your personal details, including your full name, address, contact information, and any identification numbers requested.
04
Provide accurate information regarding your current living situation and any homelessness-related circumstances.
05
Include supporting documentation or evidence, if required, to substantiate your claims.
06
Review the completed form to ensure all information is accurate and legible.
07
Sign and date the form, affirming the truthfulness of the information provided.
08
Submit the homelessness self-certification statement form to the designated authority or agency as instructed.
09
Keep a copy of the form for your records.
Who needs homelessness self certification statement?
01
Anyone who is experiencing or has experienced homelessness and needs to verify their situation may require a homelessness self-certification statement. This could include individuals applying for government assistance programs, seeking housing support, accessing healthcare services, or addressing legal matters. The specific organizations, agencies, or authorities requesting the statement may vary depending on the jurisdiction and purpose.
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