Cupertino - 2021 Recertification

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Hello Cupertino Resident!

These are unprecedented times and we hope this finds you and your loved ones well. We at Hello Housing are doing all we can to make sure that we are being proactive in preventing the spread of the coronavirus, while being steadfast in our commitment to serve our tenants and partners.

For the City of Cupertino Below Market Rate Rental program recertification process, we have created this online form which allows each household to submit their recertification and upload their supporting documents, securely, online. Once you submit your form and documents, they will transfer into our client management system. Please be assured your information is treated as strictly confidential and is never shared beyond Hello Housing and the City of Cupertino. 

All recertifications must be received by the date indicated in your recertification letter/email. Recertifications will not be accepted in person at the Hello Housing offices, nor the City of Cupertino offices, with no exceptions.

If you have any questions or concerns about submitting this information, please email or call (415) 863-3036.

Hello Housing Team 

Equal Housing Opportunity LogoHello Housing and the City of Cupertino do not discriminate against any persons on the grounds of race, color, religion, national origin, ancestry, sex, gender, gender identity, gender expression, sexual orientation, marital status, familial status, source of income, genetic information, medical condition, physical disability or mental disability, or any other category protected by law.


Please review the following steps to ensure you successfully submit a complete recertification.

1. Prepare

Please have the following information available for ALL household members before you begin to fill out the recertification:

  • Employment information, including paystubs
  • Gross annual income for each income source*
  • All financial account institutions and balances
  • Deposit clarifications for any deposits over $500
*Please note that income may include but is not limited to: Pay from an employer, Self-Employment, SSI, Pension/Annuity, Gift Income , etc. 

2. Save

If you are not able to finish filling out the recertification in one sitting, please follow these steps:

  1. Click the "Save my progress and resume later" link at the bottom of any page.
  2. You'll be prompted to submit an email and password.
  3. Afterwards you'll receive an email with a link that can be used later to open the recertification and continue working.
  4. When you return to complete the form, you will need to provide the same email and password. 

Tip: If your internet connection is inconsistent, save your progress as you go.

3. Submit

Please note the following tips before submitting your recertification:

  • All required fields must be filled in before you can submit your paperwork.
  • Any required fields left blank will be highlighted in red when you attempt to submit your recertification. 
  • Once your recertification is submitted, you will receive a confirmation email.

Household Information

Below, please provide details for the Head of Household and Co-Head of Household (if applicable), as well as all members of the household residing in the unit. Please note that household composition information is being collected for the purposes of calculating the total number of household members in regards to income eligibility and rental rates.  
Head of Household
Provide details for the Head of Household below. Please note, that the Head of Household will be the main point of contact. It is not required that the Head of Household be the most significant contributor to the family income.

Head of Household Demographics
Hello Housing believes that fair and equal access to affordable housing opportunities is critical to supporting diverse communities where people thrive. To know how we are doing, we need to collect demographic information from our applicants, buyers and renters. And, we need to collect this information in a way that can be compared with other publicly-available information.  The format and choices of the following questions mirror how these questions are asked by the U.S. Census Bureau.  

Please be assured that this information is only used in the aggregate and is not used in any way to determine your household's eligibility for any program offering. By providing this information, you are helping us better understand the reach and impact of our programs in the communities we serve, which in turn leads to more effective affordable housing solutions.

Primary Language
Your answers below help us make the program more accessible to applicants who speak different languages. Your answers will not be used in any way to determine your eligibility for this program.

Co-Head of Household

Co-Applicant Demographics

Primary Language
Your answers below help us make the program more accessible to applicants who speak different languages. Your answers will not be used in any way to determine your eligibility for this program.

Additional Household Members

Please provide information on any other members of your household, such as children, grandparents, or other adults in the household who are full or part-time residents. This information helps calculate your household size. Demographic information is not a criteria in the approval process but provides a clearer picture on the types of families who might benefit from affordable housing opportunities.

Additional Household Members

Household Member Demographics

Primary Language
Your answers below help us make the program more accessible to applicants who speak different languages. Your answers will not be used in any way to determine your eligibility for this program.

Household Assets

The information you provide on this page helps determine your eligibility for the financial requirements of the City of Cupertino BMR Program.

Please provide accurate information. Assets will be verified based on the supporting documentation submitted with this recertification.
Household Assets
Please list the current value of all assets for all members of the household aged 18 and older.

Supporting Documentation & Income

Please provide supporting documentation for all adult household members, aged 18 and over. All documents must be legible to be considered.
Documentation of All Income Sources
Please provide accurate information. Eligibility will be determined based on the gross combined household income and will be verified based on the supporting documentation requested at the end of this recertification.

Documentation of Employment Income
If employed, provide two (2) months of the most recent consecutive paystubs for all adult household members.
Documentation of Self-Employment Income
If self-employed, provide a year-to-date Profit & Loss statement.
Documentation of Social Security, SSDI, or Pension Income
Documentation of Child Support or Spousal Support
Documentation of Gift
Zero-Income Affidavit
Tax Information
If you or any household member cannot locate your returns, please contact the IRS to request tax transcripts at (800) 829–1040 or online at If you or any household member were NOT required to file taxes for ANY OR ALL of the last three (3) years, please provide a “Verification of Non-Filing”, which you can request by submitting a Form 4506-T to the IRS. This form is available online at or you may request it by contacting the IRS at (800) 829-1040.
Financial Accounts
Please include statements for ALL OPEN accounts, even if they contain a $0 balance. Computer printouts are acceptable ONLY if they contain a complete account number, begin & end balances, and begin & end dates. 

Certification of Information