wei@habcnj.org
One Bergen County Plaza, 2nd Floor, Hackensack, NJ, 07601, US
201-336-7600
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.
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?
Do you have a tenancy summons or lockout notice?
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?
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
Confirmation
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