Rent, Mortgage, and Utility Assistance Application

Please complete this application if you are seeking rent, mortgage or utility assistance due to a crisis or recent loss of employment.
Average completion time: 20 minutes

By clicking the button below, I agree that all information I provide in this application will be shared with nonprofit partners who provide rent and utility assistance.

I agree

By clicking the button below, I understand that I may need to wait 2-4 weeks to hear back from a matched agency or from ARCHI. I understand that submitting multiple applications will not improve the likelihood of receiving assistance and any resubmissions during this time will be automatically rejected.

I agree

First Name

Last Name

Date of Birth

mm/dd/yyyy

Phone number

Email address

Home address

Input your street address and apartment number(if applicable)

City

State

Zip Code

This program is specifically for those facing eviction from a current rental or owned home. If you need housing or homeless services within the City of Atlanta please contact one of the Coordinated Entry Access Points listed at

https://partnersforhome.org/ova_doc/coordinated-entry or visit the Gateway Center at 275 Pryor St. SW, Atlanta GA 30303. If you need move-in financial assistance or rapid rehousing in Atlanta, please email Crossroads at info@crossroadsatlanta.org or call 470-225-1995

Is your lease/mortgage in any way associated with Atlanta Housing Authority or HUD? (Housing Choice, Section 8, subsidized program)

YesNo

What is your monthly rent/mortgage payment?

City

State

Zip Code

Please continue filling out the application. You may be contacted for further clarification as assistance may not typically be available for private rental agreements.

If you have any additional supporting documentation to submit, you may upload below. Click the "Add Another Document" link to add more than 1 document.

Additional Document Uploads

Upload Document

Thank you for filling out this form. Please press Submit when you are ready