Evaluación de elegibilidad del programa de prevención de desalojos / Eviction Prevention Program Eligibility Screening
ESTA NO ES LA SOLICITUD DE FONDOS DE PREVENCIÓN DE DESALOJO.

Complete este formulario para determinar inicialmente la elegibilidad para los fondos de prevención de desalojo. Si es elegible, MIMA le dirigirá a CASA, Southeast CDC, Latino Economic Development Corporation o un voluntario para ayudarle con la solicitud. Para calificar, debe vivir en la ciudad de Baltimore y estar atrasado en el pago del alquiler.

THIS IS NOT THE APPLICATION FOR EVICTION PREVENTION FUNDS.

Please fill out this form to determine initially eligible for Eviction Prevention funds. If you are eligible, MIMA will direct you to CASA, Southeast CDC, Latino Economic Development Center, or a volunteer to assist you with the application.  To qualify you must live in Baltimore City and be behind on rent/owe your landlord rent.

MIMA is working in partnership with Baltimore City's Community Action Partnership (CAP) to assist immigrants with limited English proficiency to apply for the City's Eviction Prevention Program. This is a program that provides financial assistance for rental delinquencies that occurred between March and December 2020. For more information on this program, visit https://www.bmorechildren.com/eviction-prevention



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Name/Nombre *
Preferred language/Idioma preferida *
Email/Correo Electronico
Phone number/Teléfono
Street address (This program is for Baltimore City residents ONLY)/Dirección completa (Este programa es SOLO para los residentes de la Ciudad de Baltimore) *
Zip Code
Are you behind on rent?/¿Esta usted retrasado con el alquiler? *
How much do you owe?/¿Cuánto debe? *
Have you received an eviction notice?/Ha recibido una noticia de desalojo? *
If you have received an eviction notice, what is your court date?/Si ha recibido una noticia de desalojo, cual es la fecha de corte?
MM
/
DD
/
YYYY
Which months do you owe?/¿Cuales meses debe?
Are you in danger of having a utility (BGE or water) turnoff? This could mean that you have a turnoff notice, or an extremely high bill./¿Está en peligro de tener una utilidad (BGE, luz o agua) apague? Esto podría significar que tiene un aviso de desactivación o un bil extremadamente alta.
Clear selection
Do you have a child at any of the following schools?/Tiene un hijo en cualquiera de las escuelas siguentes?
Do you have COVID-19 impact proof? If not, we can support you with a self-declaration letter/Tiene pruebas de haber sido impactado por COVID-19? Si no, podemos apoyarle con una carta de auto certificacion. *
Required
What is your rental situation?/¿Cual es su situación de alquiler? *
Have you or your child tested positive for COVID-19?/ ¿Tuvo usted o su hijo/a COVID-19? *
Clear selection
Did you qualify for federal stimulus payments, unemployment insurance or PPP?/¿Usted califica para los pagos de estímulo federal, el seguro de desempleo o PPP? *
Clear selection
How did you hear about Eviction Prevention Program (EPP)/ ¿Cómo se enteró de programa de prevención de desalojos (EPP)*
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