LEAP Referral Form

Landlord Engagement and Assistance Program (LEAP)

* Indicates required field

Welcome to the San Diego Housing Commission (SDHC) Landlord Engagement and Assistance Program (LEAP) Web Referral Form. This web form can be used by homeless services providers to refer participants to the SDHC LEAP & Flexible Funding Pool (FLEX).

LEAP can assist with move-in expenses like security deposits, application fees, utility assistance, housing location assistance, and landlords can access the Landlord Contingency Fund to help cover expenses that exceed security deposits

Referral Form Questions

Referral Date: *

Is this household currently enrolled in a rental assistance program? *

Please indicate rental assistance type: *

Other rental assistance type: *

Referring Service Provider: *

Case Worker Name: *

Case Worker Phone Number: *

Case Worker Email: *

Participant Information

Name: *

Clarity ID: *

Last 4 digits of Social Security #: *

Phone:

Email:

Date of Birth *

Gender: *

Ethnicity: *

Race: *

Veteran: *

AMI *

VI SPDAT Score:

Number of Adults in Household (Inculding Participant): *

Number of Children in Household: *

Please indicate which LEAP benefits this referral needs: *

Security Deposit / Holding fee

Application Fee

Utility Assistance

Housing Location Assistance

Other

Other Needs:

Referral Type Selection *

Track 1 - Housing Location Assistance + Payment Track 2 - Payment Only

Total Monthly Income

Income Source:

Additional housing notes: