Application Checklist

  • Application of Eligibility – Fill out completely, sign and date. Each household member 18 years of age or older must sign.
  • Release Form(s) – Each household member 18 years of age and older must sign and date both the HUD Release form and the SEMMCHRA release form.
  • Privacy Notice – Sign and date
  • Proof of Income –
    • Documentation of total income from 2019 (copy of form 1040)
    • Income from the months assistance is needed
      • Social Security/SSI/Disability – Current Year’s Benefit letter
      • Wages – income from the months assistance is needed
      • Veterans Benefits/Armed Forces Pay – Award Letter
      • Pension/Retirement – Award letter
      • Self – Employment – Most current tax return, Monthly business ledgers
      • Child support – print out of at least the last six (6) months of payments
      • County assistance/Public Assistance (MFIP, TANF, GA, MSA, Food Support or any cash assistance) – Print out/statement showing the amounts received each month.
      • Unemployment – Print out of the last 6 months of payments.
    • Proof of Assets –
      • Checking – last 3 months of bank statements
      • Pre-Paid Debit card (Green Dot, MetaBank, Child Support card, Direct Express) – Statement or print out showing current balance.
      • Real Estate – copy of current tax statement
  • Proof of Need –
    • Contact information for the landlord or mortgage servicer or HOA
    • Mortgage statement (February 2020 through current month showing your current outstanding mortgage balance, monthly payment amount, amount past due, & late fees.)
    • Rent statement (February 2020 through current month)
    • Utility bills (February 2020 through current month)
    • HOA dues statement (February 2020 through current month)
    • Lot rent statement (February 2020 through current month)
    • Proof of change of employment due to COVID-19 (letter from employer, etc.)

Items on this checklist can be returned to SEMMCHRA in person or mail (134 East Second Street, Wabasha, MN 55981), by fax (651-565-3836) or email (agusa@semmchra.org)