Fillable Form 2020.: Department of Social Service (Clark County Nevada)

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Form 2020.: Department of Social Service (Clark County Nevada)

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Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702)
4
55-4270 • Fax (702) 455-5950
1
CHAP Landlord Assistance Program Overview
Have your tenants had difficulty making rent payments as a result of COVID-19?
The Clark County CARES Housing Assistance program (CHAP) will reimburse landlords for lost rent
revenue (rent and assessed late fees) due to COVID-19 between March 1, 2020 and December 30,
2020.
C
lark County reserves the right to limit the number of units funded based on availability.
ELIGIBILITY
A residential landlord is ELIGIBLE to apply for one-time assistance if:
• The property is located in Clark County Nevada.
• The landlord owns the property as of the date of application.
• The property is residential (mixed use properties will be eligible for residential leases only).
• The landlord is NOT a government entity or public housing authority.
• The landlord has not received any COVID-19 relief funds in the form of a grant or forgivable
loan.
• The landlord has not received any other funding for the same expenses from other sources.
• The landlord has written confirmation that tenants have had difficulty making rent
payments as a result of COVID-19.
ELIGIBLE LANDLORDS
• Individuals/sole proprietors or self-employed Individuals
• Corporations or limited liability companies
• Partnerships
• Non-Profits
ELIGIBLE RESIDENTIAL DWELLINGS
• Single Family Home (Including rooms rented within a home)
• Accessory Residential Unit (Carriage/Coach House/Guest House)
• Multi-Family Home
• Mobile Home
• Condominium
• Apartment
• Townhome
• Co-op
If you have additional questions, please email chaplandlords@clarkcountynv.gov
Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702) 455-4270 • Fax (702) 455-5950
2
Landlord Assistance Application Process
STEP 1. Get an application. The application is available on chap.clarkcountynv.gov under the link
“CHAP Landlord Assistance Program”.
STEP 2. Landlord fills out application. The following documentation is required before the
application will be processed:
1. Ownership documentation – one per property. Acceptable proof of ownership
documents include, but are not limited to a copy of the deed to the Property
[Properties], a copy of the mortgage, or proof of homeowner’s/hazard insurance
from the most recent year
2. Lease Agreements – one per unit on application
3. Delinquency Notices – one per unit on application
4. COVID-19 Confirmation- written confirmation that tenants on the application have
had difficulty making rent payments as a result of loss of income due to COVID-19 (see
Example 2: “COVID-19 Confirmation”).
5. W-9-to provide the legal name and address of the vendor and the taxpayer's accurate
identification number for year-end tax reporting purposes on the Form 1099.
STEP 3. Landlord provides Tenant Notice to all tenants included on the application.
Notification Requirement for Tenants
Landlords applying for the Landlord Assistance Program must provide each Tenant
included on the application with the “Tenant Notice: Clark County Landlord
Assistance Program” information document prior to submitting the application
(see Example 1). Submission of the Application certifies that the Landlord has
provided the Tenant Notifications as required here. Copies of this do not need to
be included in the application.
STEP 4. Landlord emails in application and documentation to chaplandlords@clarkcountynv.gov.
Application is reviewed by Clark County.
STEP 5. Landlord receives Determination Letter. If application is approved:
1. Clark County will notify tenant(s) that the landlord has received back rent and/or
late fees on their behalf.
2. The landlord will receive a Landlord Assistance Program Agreement. They must have it
signed and returned to the County.
STEP 6. County receives Agreement. County signs/fully executes the Agreement, sends a copy
to the Landlord and mails a check to the Landlord.
Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702)
4
55-4270 • Fax (702) 455-5950
3
Landlord Assistance Application
Date of Application:
Landlord Information
Name:
Street address:
City: _
State: Zip Code:
Phone:
Email:
Property Information
Property Name
Street Address
City
Zip
Code
Parcel
ID
Date of
Acquisition
# of
Units
Ownership
Documentation
Included.
Yes/No
Total amount of funds being requested:
Office Use Only:
Date Received:
Application #:
Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702)
4
55-4270 • Fax (702) 455-5950
4
Landlord Assistance Application
Primary Lease Holder Information
Property Name:
Primary Lease Holder Name:
If Primary Lease Holder’s address is the same as the property address, you may just enter Unit # below and
skip to the Phone field.
Street address: Unit #:
City:
Zip Code:
Phone:
Email:
A T
enant Notice was provided to the tenant for this unit:
Yes No
T
he following documents are included for this unit:
1. Lease Agreement: Yes No
2. Delinquency Notices: Yes No
3. COVID Confirmation: Yes No
The breakdown of itemized cost:
MM/YYYY
AMOUNT
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Rent
/
$
Late Fees
/
$
Other:
Deposit
/
$
TOTAL:
$
Department of Social Service
1600 Pinto Lane • Las Vegas NV 89106
(702) 455-4270 • Fax (702) 455-5950
5
Example 1. Tenant Notice: Clark County Landlord Assistance Program
Today’s Date:
Your landlord is applying to Clark County for financial assistance under the Clark County Landlord
Assistance Program to cover the rent and assessed late fees you have been unable to pay because of
hardships related to COVID-19 between March 1, 2020 and December 30, 2020. You will be notified
by Clark County if the assistance is awarded to your landlord and, as a result, whether you no longer
owe the rent to your landlord.
As a courtesy, this tenant notice is intended to notify you that your landlord will provide Clark County
with information about you, including your name, address, phone number, email address, and
amount of rent owed, as part of the landlord’s submitted application. Clark County is collecting this
information about you to ensure eviction proceedings do not proceed for any months in which your
landlord has been paid under the program, and, to be sure your rent is not paid from another source.
Clark County may need to share your information with auditors, government regulators or others
who have a legal right to access it. Your information may also be used to contact you about other
assistance that is available.
------------------------------------------------------------------
Example 2. COVID-19 Confirmation
Today’s Date:
Landlord’s Name:
Primary Lease Holder’s Name:
The Landlord named above has confirmed with the Primary Lease Holder named above that
difficulty making rent payments is the result of loss of income due to COVID-19. Reason(s)
include (check all that apply):
o Laid off
o Place of employment has closed
o Loss of work hours
o Must stay home to care for children due to closure of day care and/or school
o Reduction or elimination of child or spousal support
o Not able to work and/or missed hours due to contracting COVID-19
o Unable to find work due to COVDI-19
o Unwilling or unable to participate in their previous employment due to their high risk of
severe illness from COVID-19
o Other:
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Form 2020.: Department of Social Service (Clark County Nevada)

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Completed 19 October 2021

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