Emergency Funds Network Forms & Resources
The purpose of this website is to provide you with timely updates to required forms and documents.
If you have any questions or concerns, please contact Melissa Soden at melissa.soden@hfuw.org.
Form / Document | Use | Revision Date |
Provides detailed information on the Emergency Funds Network, including guidelines for fund usage and required documentation. | 08/22/2019 | |
Updated list of reasons for service codes with explanations. | 07/25/2019 | |
EAR Form | Required for all assistance requests; provides comprehensive information on the client served which match information entered into MAACLink. | 06/13/2019 |
EAR Additional Members | Use this form to list any additional members in the household not included on the EAR. | 06/13/2019 |
Must be submitted for all vendors/payees that are individuals and/or an LLC. | October 2018 | |
RENT / MORTGAGE ASSISTANCE | ||
Landlord-Property Manager Caseworker Verification Form | The landlord/property manager must complete this form for rental properties, verifying the amount of rent owed. This version includes the late fee waiver. | 06/13/2019 |
Landlord/ Property Manager-Caseworker Verification Form | The landlord/property manager must complete this form for rental properties, verifying the amount of rent owed. This version does not include the late fee waiver; late fees are the client's responsibility. | 06/13/2019 |
Landlord/Property Manager-Case Worker Form (First Month) | The landlord/property manager must complete this form for rental propertirs, verifying the amount of rent owed. This version states landlord will return check to HFUW if the client is not able to move-in. This version includes the late fee waiver and is for first month only. | 06/13/2019 |
Mortage Holder-Case Manager Verification Form | The caseworker must complete this form providing information about the mortgage and mortgage holder. | 06/13/2019 |
Rental Agreement Form | Use this form for a client that is moving into housing, but does not yet have a signed lease. This form is most applicable for clients being rehoused and are receiving move-in assistance. | 06/13/2019 |
Property Appraiser Verification Form | This form should only be used when the agency is unable to obtain updated information from the appropriate property appraiser's website. | 06/13/2019 |
UTILITY ASSISTANCE | ||
Duke Energy Application for Special Medical Needs | Application for the Duke Energy Special Medical Needs Program. Packet must include: this form, an EAR, Physician's letter, and household members identification. Send packet to ehs@hfuw.org | 10/24/2013 |
EMERGENCY FOOD & SHELTER PROGRAM (EFSP) |
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The following documents should only be used by organizations awarded EFSP funding. Please ensure your organization is using the correct forms for the correct EFSP Phase. For any questions or assistance regarding EFSP, please contact Mikaela (Mika) Mendoza-Cardenal at efsp@hfuw.org. |
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EFSP Spending Periods |
Phase 42: January 1, 2025 to December 31, 2025
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EFSP Phase 35 Manual | This manual includes pertinent information regarding the Emergency Food & Shelter Program. This manual was released during Phase 35 and a new manual has not yet been issued. | Phase 35 & Subsequent Phases |
EFSP LRO Training Presentation |
SHELTER, FOOD and MEALS TRAINING For case management training use the following link https://www.youtube.com/watch?v=obF2RcxXODQ |
Phase 42 |
EFSP Case Management Standards | Describes the preferred case management standards for clients receiving rent, mortgage, and/or utility assistance. | 10/18/2016 |
Mass Shelter Daily Per Diem Log |
The per diem allowance is exactly $12.50 per person per night for LROs providing mass shelter services (five beds or more in one location). For Payment: LROs must go to Adsystech to:
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Other Shelter Assistance Form (Off-Site Lodging Hotel/Motel) |
For other shelter assistance, eligible program costs include off-site emergency lodging (room and tax only) in a hotel/motel or other off-site shelter facility. Assistance is limited to 30-days assistance per individual or household during the current program period. EFSP funds can only be used once the client/household has checked out of the hotel/motel. If the client/household is currently staying in the hotel/motel, EFSP will not process this payment request. HFUW will issue the payment directly to the vendor. For Payment: LROs must ensure all client information (household profile, income and expenses, and case notes) is entered in HFUW's client management system Adsystech and:
Remember: Unpaid invoices must include the client's name, length of stay, and charge per night. EFSP funds cannot be used to reimbruse the LRO or provide advance payments/prepayments to the vendor (hotel/motel). An LRO receiving funds may not act as a vendor for themselves or another funded LRO. |
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Meals Served Per Diem Log |
The per meal allowance is exactly $3.00 per meal served for LROs providing congregate meal services. For Payment: LROs must go to HFUW's client management system Adsystech to:
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Other Food Expenditures |
The purchase of food, food vouchers, and gift certificates for food. The purchase of gift certificates for food must be marked “Food Only”, "Food & Diapers Only" or Food, Diapers & Feminine Hygiene Items Only”. HFUW will issue the payment directly to the food vendor within 90 days of the invoice date. For Payment: LROs must go to HFUW's client management system Adsystech :
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Other Food- Food Banks **Second Harvest Food Bank Only** |
Includes the purchase of food, food vouchers, and gift certificates for food (gift certificates must be marked “Food Only”). Only food banks may operate under EFSP as both a vendor and an LRO. LROs must submit dated unpaid invoices vouchers for food purchased. HFUW will issue the payment directly to the food vendor within 90 days of the invoice date. For Payment: LROs must go to HFUW's client management system Adsystech and:
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Rent and Mortgage Assistance Verfication Form |
Limited emergency rent or mortgage assistance (principal and interest only) for individuals or households. LROs may now pay up to three (3) months of rent/mortgage assistance per phase if it is necessary to maintain housing.HFUW will issue the rent or mortgage payment directly to the landlord/mortgage company. For Payment: LROs must ensure all client information (household profile, income and expenses, and case notes) is entered in HFUW's client management system Adsystech. A complete packet must include the following:
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Utility Assistance Verification Form |
Limited metered utility assistance (includes gas, electricity, water, and sewer service) for individuals or households. LROs may now pay up to three (3) months of utility assistance per phase if it is necessary to prevent disconnection of services. The client must be 1) a resident of the home or apartment and 2) responsible for the utility on the home or apartment for which utility assistance is to be paid.HFUW will issue the utility payment directly to the utility company. For Payment: LROs must ensure all client information (household profile, income and expenses, and case notes) is entered in HFUW's client management system Adsystech. A complete packet must include the following:
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Additional Information and Resources United Way 211 Community Resource Directory Florida Department of Business & Professional Regulation (dbpr) (Housing Inspection Reports and Housing License Search) Florida Department of Highway Safety and Motor Vehicles (DMV Driver's License Search) Florida DCF Child Care Provider Search Florida Division of Corporations (Sunbiz) Orange County Property Appraiser Osceola County Property Appraiser Osceola County Clerk of the Circuit Court Seminole County Property Appraiser Seminole County Clerk of Courts EFN Training 7-25-2019 (Includes info on W-9s) EFN Training 10-22-2019 (Includes info on Duke Energy Special Medical Needs) |