Fillable Tenant Confirmation for Previous Dwelling

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Tenant Confirmation for Previous Dwelling

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The Tenant Confirmation for Previous Dwelling form is 1 page long and contains:

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  • 4 check-boxes
  • 4 other fields

Country of origin: OTHERS
File type: PDF

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Tenant Confirmation for Previous Dwelling
You can now apply for rent assistance for a unit you have moved out of.
The property listed in this application is:
___ My primary address
___ I have moved out and am seeking assistance for rent debts
(Please complete the section below)
I, confirm that I am no longer living at
(the “Previous Dwelling”). I am applying for assistance with back owed rent and/or utilities for
the Previous Dwelling through RentHelpMN.
Please choose one:
□ I confirm that I want the rent/utilities debt paid through RentHelpMN for the Previous
Dwelling in order to help remove barriers I may face in accessing future housing.
□ I withdraw my request for rent/utilities assistance for the Previous Dwelling.
I understand that emergency rental assistance is limited to 18 months per household and that
any assistance used to pay for rent owed on a previous dwelling will count towards that limit.
SIGN HERE:
DATE:
RentHelpMN COVID-19 Emergency Rental Assistance
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Tenant Confirmation for Previous Dwelling

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Completed 13 October 2021

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