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Housing Authority of Bergen County

wei@habcnj.org

One Bergen County Plaza, 2nd Floor, Hackensack, NJ, 07601, US

201-336-7600

Homeless Prevention Application

Are you a Bergen County Resident?

Ineligible due to not being a Bergen County Resident.

Do you receive assistance for your rent? (Such as Section 8 rental assistance or other housing subsidy)

Ineligible due to subsidy assistance.

Has your household been impacted by COVID19?

Full Name

Full Address

Are you currently receiving services from a homeless service provider?

Social Worker/Case Manager Name

What type of assistance do you need?

Are you behind on your rent?

Are you behind on your rent?

Do you have a tenancy summons or lockout notice?

Please be advised due to current federal and state eviction moratorium we are unable to proceed with your application, you may reapply at a later date upon the lifting of the state’s eviction moratorium. Please visit nj211.org for further assistance. 

Do you have a tenancy summons or lockout notice?

Please be advised due to current federal and state eviction moratorium we are unable to proceed with your application, you may reapply at a later date upon the lifting of the state’s eviction moratorium. Please visit nj211.org for further assistance. 

Are you living in an a place not meant for human habitation, emergency shelter , or transitional housing? If yes when did you become homeless?

When did you become homeless?

Date Picker

Are you temporarily living with friends or family?

Please be advised, you are not at risk of homelessness, you may reapply at a later date. Please visit habcnj.org/apply for other housing opportunities.

Are they asking you to leave the residence?

Full Name

Full Address

Have you or a family member been impacted by Covid-19 If so, please select the situation which most closely describes your situation

What type of assistance do you need?

Are you living in an a place not meant for human habitation, emergency shelter , or transitional housing?

When did you become homeless?

Date Picker

Are you temporarily living with friends or family?

Please be advised, you are not at risk of homelessness, you may reapply at a later date. Please visit habcnj.org/apply for other housing opportunities.

Confirmation

You will be provided with a Confirmation upon submission.

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