About Us
ERAP
How it works
FAQ
Apply For Relief Fund
Rent Relief Application
Personal Information
First Name
*
Last Name
*
Phone Number
*
Social Security Number (SSN)
*
Gender
*
Male
Female
Date of Birth
*
Do you have an income
*
Yes
No
2021 AGI (Annual Gross Income)
*
Have you file 2022 tax return
*
Yes
No
Drivers License Number
*
Address
*
Email
*
Confirm Email
*
Front of your State ID/License
*
Back of your State ID/License
*
Grant Payment Information
How to receive the grant
*
Direct Deposit
Account Type
*
Checking
Savings
Routing Number
*
Account Number
*
Submit Application
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