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 a place not meant for human habitation, emergency shelter , or transitional housing?
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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