Hardship and Exception Requests

10.16.2024: Please note that review of all hardships and exceptions may take up to 5 business days due to current staffing levels. If this is URGENT, please email Kelsey Beckmeyer directly once you submit this form - kelsey.beckmeyer@kcrha.org. Otherwise, you will receive a response within the 5 day time period.

Organization

Name of Project

Contract Number

Program Type

Fund Source(s)

Please select what fund source(s) this request relates to:

Request Type

Please select what type of request this is:

NOTE: For RRH or YET & Nav/Div, please check the hardship request if related to the rental subsidy extension or emergency rental assistance

Participant HMIS ID

DO NOT INCLUDE NAMES

Name of Person Submitting Request:

Email of Person Submitting Request:

Email of Program Supervisor/Manager

Agreement and Signature

By submitting this form, I affirm that I or another staff member reviewed this request with the participant, the participant consented to this request, and my responses are true and complete to the best of my knowledge.

Send me a copy of my responses

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