1. The tenant and unit listed in the application have not and are not receiving any other form of
government or private assistance for the same months and amount of rent for which this
assistance is requested, including, without limitation, Mississippi Rental Assistance Program,
Community Block Grant, Emergency Solutions Grant, and Housing Opportunities for Persons with
AIDS programs, and the Landlord will not seek any other such assistance for the same months and
amount of rent. If Landlord receives any such assistance, Landlord will repay Emergency Rental
Assistance Program funds to MHC within ten (10) calendar days of receipt of such assistance.
2. If the written lease or oral agreement is expired or will expire during the period covered by this
assistance, Landlord will enter into a new written lease or extend the current lease with tenant
for a monthly payment amount no greater than the monthly amount for the expired or expiring
lease or agreement, for a time period at least equal to the period covered by the Emergency
Rental Assistance Program. The new lease may not increase or impose other fees or charges not
provided for under the current lease.
3. Late fees and penalties for nonpayment of rent incurred prior to the date of this application, an
d
fo
r each month thereafter for which an Emergency Rental Assistance Program payment is
accepted by Landlord
, shall be discharged.
4. Landlord hereby releases the tenant and the tenant’s household for payment liability, and will not
evict the tenant for any reason that predates the acceptance of the Emergency Rental Assistance
Program funds for any reason related to rent or fees or nonmonetary defaults, except for actions
or breaches of the lease related to criminal activity, property damage or physical harm to others,
from the date of this Agreement until the date that is ninety (90) days after Landlord receives the
last Emergency Rental Assistance Program payment from MHC (the “Restrictive Period”). If a
tenant has a month
‐to‐month lease, Landlord shall continue the lease during the Restrictive
Period.
5. Any Emergency Rental Assistance Program payments received by the Landlord shall be used to
satisfy the tenant’s rental obligations.
6. Landlord has not filed eviction proceedings for this unit, or if Landlord has filed eviction
proceedings, they have been dismissed prior to the date of this application.
7. Landlord is not the relative of any member of a tenant’s household. (”Relative” means a child,
parent, sister, brother, grandparent, aunt or uncles, including step
‐ and in‐law relationships.)
8. Landlord will provide the U.S. Department of Treasury, the U.S. Inspector General, the U.S.
General Accounting Office, the Mississippi State Auditor’s Office, MHC or any of their duly
authorized representatives access to and the right to examine and copy records.
Please Note: The information listed on this Agreement
is for rental assistance with Emergency Rental
Assistance Program. Your signature below certifies that you are agreeing to participate as
Landlord/Legal Owner in the Emergency Rental Assistance Program.
________________________________________________________ __________
LANDLORD/ LEGAL OWNER SIGNATURE Date
BY:___________________________________________________
(Name)
ITS:___________________________________________________
(
Title)
