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Eviction Prevention Program

ADMINISTERED BY THE COMMUNITY INVESTMENT CORPORATION

Tenant Info
Landlord Updates
Are you eligible?
Apply for Waiting List
Utility Support

Tenant Info
Landlord Updates
Are you eligible?
Apply for Waiting List
Utility Support

Eviction Prevention Case Submission

Welcome to our Eviction Prevention Case Submission page. We're here to help.

In this form, we're asking for basic information, like tenant + landlord contact information. Submitting this to us will get your case started and hold your place in line. We will follow up afterwards to collect more information from you and have you fill out a full application.
Before we get started, please tell us whether you are the...*
- Tenant
- Landlord/Property Manager

Tenant Information
Full Legal Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
- Email Address
- Primary Phone Number*
We noticed you entered an email with a "+" sign in it. Unfortunately, we can't accept emails formatted this way. Please choose another email address.
Is this a cell phone?
- Yes
- No
May we send you a text message first to let you know we're calling?*
- Yes
- No
Is there another number where we may reach you?
- Yes
- No
Secondary Phone*
Is this second number a cell phone?*
- Yes
- No
May we send you a text message before calling?*
- Yes
- No
Landlord / Property Manager Information
In some cases, we need to reach out to the landlord to collect information from them.
Would you like to provide contact information for your landlord so we may reach out to them?*
- Yes
- No, I will reach out to them myself.
Landlord / Property Manager Information (Hidden)
Landlord/Property Manager Name*
First Last
- Email
- Phone
We noticed you entered an email with a "+" sign in it. Unfortunately, we can't accept emails formatted this way. Please choose another email address.

Landlord / Property Manager Information
Please share your contact information with us, so that we can get your case into the system and reach out to you.
Your Name*
First Last
- Email*
- Phone*
We noticed you entered an email with a "+" sign in it. Unfortunately, we can't accept emails formatted this way. Please choose another email address.
Tenant and Property Information
Tenant's Name*
If more than one tenant, please provide info for the tenant you expect to be most responsive in getting this case processed.
First Last
- Tenant Email
- Tenant Phone Number
We noticed you entered an email with a "+" sign in it. Unfortunately, we can't accept emails formatted this way. Please choose another email address.
Tenant Property Address*
Street Address Address Line 2 City State ZIP Code
Would you like us to reach out to the tenant directly about this program?*
- Yes
- No, I will reach out.

We noticed you left some of the contact information (phone number and/or email) blank on the previous page. If you left it blank because you don't have the info, that's fine. However, the more info you can provide, the faster we can get your case started.

Feel free to click "Previous" and review the missing information. Otherwise, answer this last question and you're done!
Is there anything else you'd like us to know?

Eviction Prevention Program

Administered by the Community Investment Corporation

Tenant Info
Landlord Updates
Are you eligible?
Apply for Waiting List
Utility Support

Community Investment Corporation is a registered 501(c)(3) charity. © 2021. This institution is an equal opportunity provider.
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