By clicking Submit, I attest that:
I live at and am responsible for the rent to which this funding will be applied.
I am the head of household/lessee.
My household has not/will not receive any other CARES rent assistance from a Montgomery County agency between 1/27/2020 and 5/31/2021.
I have provided complete and accurate household financial information.
I have provided complete and accurate contact information for my landlord.
I will provide all required supporting household documentation (copy of rental agreement/lease; income, bank, utility, loan documents; proof of childcare expense; etc).