CoC Forms
The Santa Clara County CoC understands the importance of program compliance and have created forms that can be used as tools to assist service providers in complying with complex components of implementation.
Program Management
- Addendum for CoC Lease Requirements
- Environmental Review for CEST Activities
- Environmental Review for Exempt/CENST (Categorically Excluded Not Subject To) Activities
- HUD Model DV Certification Form
- HUD Model Notice of Occupancy Rights Form
- Landlord Certification Form Under CoC HQS Waiver
- Rent Reasonableness Checklist and Certification
- RRH to PSH Transfer Request Form
Eligibility Verification
- Homelessness Documentation Checklist
- Chronic Homelessness Documentation Checklist
- DedicatedPLUS PSH Eligibility Checklist
- Form A - Homelessness Certification
- Form B - Observation of Living Conditions
- Form C - Certification Based on Provider Judgement
- Form D - Verification of Disability
- Form E - Homelessness Self-Declaration
- Form F - Certification Based on Intake Conversation
- Form G - Certification Based on Intake Conversation or Intake Staff Observation
Income Eligibility
- Sample Form - Third Party Certification of Income
- Sample Form - Client Self-Certification of Income
HPAT
SPDAT
- VI-SPDAT for Single Adults
- VI-SPDAT for Families with Children
- VI-SPDAT for Transition Age Youth
- VI-SPDAT for Justice Discharges