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Montgomery County, Maryland Department of Health and Human Services Services to End and Prevent Homelessness

hss@montgomerycountymd.gov

COVID Rent Relief Program Waitlist

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By submitting my information below I understand that I am being placed on a waitlist for the COVID Rent Relief Program. If additional funding becomes available I may be contacted to complete a full application. 

Full Name

What is your date of birth?

Please provide your full address including apartment number

Do you have a formal lease with your landlord/property? (There is a signed document between you and the landlord that clearly states how much rent is owned each month and what are the terms and conditions of staying in the apartment.)

I understand by submitting this form that I will be added to the waitlist for the COVID Rent Relief Program. I may be contacted by Montgomery County, Maryland Department of Health and Human Services if additional funding becomes available. This form does not guarantee any funding.