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NOTICE TO QUIT POSSESSION
TO TIARA COBB
JANE DOE
31 Jaidee Drive
East Hartford, Connecticut
This is to give you notice that you are to quit possession of the
premises known as:
31 Jaidee Drive, East Hartford, Connecticut
now occupied by you on or before the 11t® day of January 2024
This notice is given for the following reason:
TERMINATION OF LEASE DUE TO NONPAYMENT OF RENT and YOU NEVER
HAD THE RIGHT OR PRIVILEGE TO OCCUPY THE PREMISES
Notice is hereby given that effective this date any tender of
money for rent shall be accepted by the Landlord for Use and Occupancy
only.
Dated at Hartford, Connecticut this 4th day of December 2023
aS, HX? QO
Elliot J.
1-36 Jaidee
RSD Rsq., Attorney
e Associates LP
for
Enclosure: HUD Form 5380 and HUD Form 5382
STATE OF CONNECTICUT:
pen b, Co2z3
ss. East Hartford ?&e™
COUNTY OF HARTFORD
THEN I MADE due and legal service of the foregoing Notice to
4 “a’true
Quit Possession, HUD Form 5380 and HUD For 5382, and Notice to Tenants
pursuant to Public Act 21-34, by leavi n and attested copy
(with ) at the usual place of abode of the within named: Tiara Cobb,
Jane Doe, 31 Jaidee Drive, East Hartford
of said town
ATTE
LLIOT J. LANE
ATTORNEY AT LAW Ww
111 OAK STREET Charles illey
HARTFORD, CT 06106
aoe State Marshal
(60) 525-7180 Hartford County
JURIS #33123
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(3 Lo
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ie
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learn about the eviction referrals for housing, utility, about the eviction process Eviction Prevention Fund by visiting
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POR INTERNET Para informacion y FORMULARIOS DEDESALOJOS
Visite ctlawhelp.org/eviction derivacionesa programas Visite cteviction.guide para Para verificar si reine los
para obtener informacién sobre de asistencia con el alquiler, obtener informacién sobre el requisitos para recibir asistencia
el proceso de desalojo y como servicios puiblicosy alimentos, proceso de desalojo y cémo. del Fondo Preventivo de
respondera una notificacién llame al 211 or visite 211ct.org, completar los farmularios Desalojos de UniteCT, visite
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Revised 2/24/2023
NOTICE OF OCCUPANCY RIGHTS UNDER U.S. Department of Housing and Urban Development
THE VIOLENCE AGAINST WOMEN ACT OMB Approval No. 2577-0286
Expires 06/30/2017
EASTON PLACE APARTMENTS
Notice of Occupancy Rights under the Violence Against Women Act!
To all Tenants and Applicants
The Violence Against Women Act (VAWA) provides protections for victims of domestic
violence, dating violence, sexual assault, or stalking. VAWA protections are not only available
to women, but are available equally to all individuals regardless of sex, gender identity, or sexual
orientation.* The U.S. Department of Housing and Urban Development (HUD) is the Federal
agency that oversees that Low Income Housing Tax Credit (LIHTC) Program is in
compliance with VAWA. This notice explains your rights under VAWA. A HUD-approved
certification form is attached to this notice. You can fill out this form to show that you are or
have been a victim of domestic violence, dating violence, sexual assault, or stalking, and that you
wish to use your rights under VAWA.”
Protections for Applicants
Tf you otherwise qualify for assistance under Low Income Housing Tax Credit (LIMTC)
Program, you cannot be denied admission or denied assistance because you are or have been a
victim of domestic violence, dating violence, sexual assault, or stalking.
Protections for Tenants
If you are receiving assistance under Low Income Housing Tax Credit (LIHTC) Program,
you may not be denied assistance, terminated from participation, or be evicted from your rental
' Despite the name of this law, VAWA protection is available regardless of sex, gender identity, or sexual
orientation.
* Housing providers cannot discriminate on the basis of any protected characteristic, including race, color, national
origin, religion, scx, familial status, disability, or age. HUD-assisted and HUD-insured housing must be made
available to all otherwise cligible individuals regardless of actual or perceived sexual orientation, gender identity, or
marital status.
Form HUD-5380
(12/2016)
housing because you are or have been a victim of domestic violence, dating violence, sexual
assault, or stalking.
Also, if you or an affiliated individual of yours is or has been the victim of domestic violence,
dating violence, sexual assault, or stalking by a member of your houschold or any guest, you
may not be denied rental assistance or occupancy rights under Low Income Housing Tax
Credit (LIHTC) Program solely on the basis of criminal activity directly relating to that
domestic violence, dating violence, sexual assault, or stalking.
Affiliated individual means your spouse, parent, brother, sister, or child, or a person to whom
you stand in the place of a parent or guardian (for example, the affiliated individual is in your
care, custody, or control); or any individual, tenant, or lawful occupant living in your household.
Removing the Abuser or Perpetrator from the Household
HP may divide (bifurcate) your lease in order to evict the individual or terminate the assistance
of the individual who has engaged in criminal activity (the abuser or perpetrator) directly relating
to domestic violence, dating violence, sexual assault, or stalking.
If HP chooses to remove the abuser or perpetrator, HP may not take away the rights of eligible
tenants to the unit or otherwise punish the remaining tenants. If the evicted abuser or perpetrator
was the sole tenant to have established eligibility for assistance under the program, HP must
allow the tenant who is or has been a victim and other household members to remain in the unit
for a period of time, in order to establish eligibility under the program or under another HUD
housing program covered by VAWA, or, find alternative housing.
In removing the abuser or perpetrator from the household, HP must follow Federal, State, and
local eviction procedures. In order to divide a lease, HP may, but is not required to, ask you for
Form HUD-5380
(12/2016)
documentation or certification of the incidences of domestic violence, dating violence, sexual
assault, or stalking.
Moving to Another Unit
Upon your request, HP may permit you to move to another unit, subject to the availability of
other units, and still keep your assistance. In order to approve a request, HP may ask you to
provide documentation that you are requesting to move because of an incidence of domestic
violence, dating violence, sexual assault, or stalking. If the request is a request for emergency
transfer, the housing provider may ask you to submit a written request or fill out a form where
you certify that you meet the criteria for an emergency transfer under VAWA. The criteria are:
(1) You are a victim of domestic violence, dating violence, sexual assault, or
stalking. If your housing provider does not already have documentation that you
are a victim of domestic violence, dating violence, sexual assault, or stalking,
your housing provider may ask you for such documentation, as described in the
documentation section below.
(2) You expressly request the emergency transfer. Your housing provider may
choose to require that you submit a form, or may accept another written or oral
request.
(3) You reasonably believe you are threatened with imminent harm from
further violence if you remain in your current unit. This means you have a
reason to fear that if you do not receive a transfer you would suffer violence in the
very near future.
OR
Form HUD-5380
in
(24 2 016)
You are a victim of sexual assault and the assault occurred on the premises
during the 90-calendar-day period before you request a transfer. If you are a
victim of sexual assault, then in addition to qualifying for an emergency transfer
because you reasonably believe you are threatened with imminent harm from
further violence if you remain in your unit, you may qualify for an emergency
transfer if the sexual assault occurred on the premises of the property from which
you are seeking your transfer, and that assault happened within the 90-calendar-
day period before you expressly request the transfer.
HP will keep confidential requests for emergency transfers by victims of domestic violence,
dating violence, sexual assault, or stalking, and the location of any move by such victims and
their families.
HP’s emergency transfer plan provides further information on emergency transfers, and HP must
make a copy of its emergency transfer plan available to you if you ask to see it.
Documenting You Are or Have Been a Victim of Domestic Violence, Dating Violence,
Sexual Assault or Stalking
HP can, but is not required to, ask you to provide documentation to “certify” that you are or have
been a victim of domestic violence, dating violence, sexual assault, or stalking. Such request
from HP must be in writing, and HP must give you at least 14 business days (Saturdays,
Sundays, and Federal holidays do not count) from the day you receive the request to provide the
documentation. HP may, but does not have to, extend the deadline for the submission of
documentation upon your request.
Form HUD-5380
(12/2016)
You can provide one of the following to HP as documentation. It is your choice which of the
following to submit if HP asks you to provide documentation that you are or have been a victim
of domestic violence, dating violence, sexual assault, or stalking.
° A complete HUD-approved certification form given to you by HP with this notice, that
documents an incident of domestic violence, dating violence, sexual assault, or stalking.
The form will ask for your name, the date, time, and location of the incident of domestic
violence, dating violence, sexual assault, or stalking, and a description of the incident.
The certification form provides for including the name of the abuser or perpetrator if the
name of the abuser or perpetrator is known and is safe to provide.
A record of a Federal, State, tribal, territorial, or local law enforcement agency, court, or
administrative agency that documents the incident of domestic violence, dating violence,
sexual assault, or stalking. Examples of such records include police reports, protective
orders, and restraining orders, among others.
A statement, which you must sign, along with the signature of an employee, agent, or
volunteer of a victim service provider, an attorney, a medical professional or a mental
health professional (collectively, “professional”) from whom you sought assistance in
addressing domestic violence, dating violence, sexual assault, or stalking, or the effects of
abuse, and with the professional selected by you attesting under penalty of perjury that he
or she believes that the incident or incidents of domestic violence, dating violence, sexual
assault, or stalking are grounds for protection.
Any other statement or evidence that HP has agreed to accept.
If you fail or refuse to provide one of these documents within the 14 business days, HP does not
have to provide you with the protections contained in this notice.
Form HUD-5380
(12/2016)
6
If HP receives conflicting evidence that an incident of domestic violence, dating violence, sexual
assault, or stalking has been conmnitted (such as certification forms from two or more members
ofa houschold each claiming to be a victim and naming one or more of the other petitioning
household members as the abuser or perpetrator), HP has the right to request that you provide
third-party documentation within thirty 30 calendar days in order to resolve the conflict. If you
fail or refuse to provide third-party documentation where there is conflicting evidence, HP does
not have to provide you with the protections contained in this notice.
Confidentiality
HP must keep confidential any information you provide related to the exercise of your rights
under VAWA, including the fact that you are exercising your rights under VAWA.
HP must not allow any individual administering assistance or other services on behalf
of HP (for
example, employees and contractors) to have access to confidential information unless for
reasons that specifically call for these individuals to have access to this information under
applicable Federal, State, or local law.
HP must not enter your information into any shared database or disclose your information to any
other entity or individual. HP, however, may disclose the information provided ift
You give written permission to HP to release the information on a time limited basis.
HP needs to use the information in an eviction or termination proceeding, such as to evict
your abuser or perpetrator or terminate your abuser or perpetrator from assistance under
this program,
A law requires HP or your landlord to release the information.
Form HUD-5380.
(12/2016)
VAWA does not limit HP’s duty to honor court orders about access to or control of the property.
This includes orders issued to protect a victim and orders dividing property among household
members in cases where a family breaks up.
Reasons a Tenant Eligible for Occupancy Rights under VAWA May Be Evicted or
Assistance May Be Terminated
You can be evicted and your assistance can be terminated for serious or repeated lease violations
that are not related to domestic violence, dating violence, sexual assault, or stalking committed
against you. However, HP cannot hold tenants who have been victims of domestic violence,
dating violence, sexual assault, or stalking to a more demanding set of rules than it applies to
tenants who have not been victims of domestic violence, dating violence, sexual assault, or
stalking.
The protections described in this notice might not apply, and you could be evicted and your
assistance terminated, if HP can demonstrate that not evicting you or terminating your assistance
would present a real physical danger that:
1) Would occur within an immediate time frame, and
2) Could result in death or serious bodily harm to other tenants or those who work on the
property.
If HP can demonstrate the above, HP should only terminate your assistance or evict you if there
are no other actions that could be taken to reduce or eliminate the threat.
Other Laws
VAWA does not replace any Federal, State, or local law that provides greater protection for
victims of domestic violence, dating violence, sexual assault, or stalking. You may be entitled to
Form HUD-5380
(12/2016)
8
additional housing protections for victims of domestic violence, dating violence, sexual assault,
or stalking under other Federal laws, as well as under State and local laws.
Non-Compliance with The Requirements of This Notice
You may report a covered housing provider’s violations of these rights and seek additional
assistance, if needed, by contacting or filing a complaint with Connecticut Housing Finance
Authority (CHFA) 999 West Street, Rocky Hill, CT 06067 (860) 721-9501.
For Additional Information
‘You may view a copy of HUD’s final VAWA rule at
https://www.federalregister.gov/documents/2016/11/16/2016-25888/violence-against-women-
reauthorization-act-of-2013-implementation-in-hud-housing-prog Se
Additionally, HP must make a copy of HUD’s VAWA regulations available to you if you ask to
see them.
For questions regarding VAWA, please contact Frank Stellato 860-838-4899.
For help regarding an abusive relationship, you may call the National Domestic Violence Hotline
at 1-800-799-7233 or, for persons with hearing impairments, 1-800-787-3224 (TTY). You may
also contact Domestic Violence Services of Meriden at (203) 238-1501.
For tenants who are or have been victims of stalking seeking help may visit the National Center
for Victims of Crime’s Stalking Resource Center at https:/Avww.victimsofcrime.org/our-
programs/stalking-resource-center.
For help regarding sexual assault, you may contact The Women and Families Center, Meriden
Hotlne at (203) 235-4444,
Victims of stalking seeking help may contact VictimConnect/National Hotline for Crime
Victims (855) 484-2846,
Attachment: Certification form HUD-5382
Form HUD-5380
(12/2016)
CERTIFICATION OF -S. Department of Housing OMB Approval No. 2577-0286
DOMESTIC VIOLENCE, and Urban Development Exp. 06/ 3 0: 2017
DATING VIOLENCE,
SEXUAL ASSAULT, OR STALKING,
AND ALTERNATE DOCUMENTATION
Purpose of Form: The Violence Against Women Act (“VAWA”) protects applicants, tenants, and
program participants in certain HUD programs from being evicted, denied housing assistance, or
terminated from housing assistance based on acts of domestic violence, dating violence, sexual assault, or
stalking against them. Despite the name of this law, VAWA protection is available to victims of domestic
violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity, or sexual
orientation.
Use of This Optional Form: If you are seeking VAWA protections from your housing provider, your
housing provider may give you a written request that asks you to submit documentation about the incident
or incidents of domestic violence, dating violence, sexual assault, or stalking,
In response to this request, you or someone on your behalf may complete this optional form and submit it
to your housing provider, or you may submit one of the following types of third-party documentation:
(1) A document signed by you and an employee, agent, or volunteer of a victim service provider, an
attorney, or medical professional, or a mental health professional (collectively, “professional”) from
whom you have sought assistance relating to domestic violence, dating violence, sexual assault, or
stalking, or the effects of abuse. The document must specify, under penalty of perjury, that the
professional believes the incident or incidents of domestic violence, dating violence, sexual assault, or
stalking occurred and meet the definition of “domestic violence,” “dating violence,” “sexual assault,” or
“stalking” in HUD’s regulations at 24 CFR 5.2003
(2) A record ofa Federal, State, tribal, territorial or local law enforcement agency, court, or
administrative agency; or
(3) At the discretion of the housing provider, a statement or other evidence provided by the applicant or
tenant.
Submission of Documentation: The time period to submit documentation is 14 business days from the
date that you receive a written request from your housing provider asking that you provide documentation
of the occurrence of domestic violence, dating violence, sexual assault, or stalking. Your housing
provider may, but is not required to, extend the time period to submit the documentation, if you request an
extension of the time period. If the requested information is not received within 14 business days of when
you received the request for the documentation, or any extension of the date provided by your housing
provider, your housing provider does not need to grant you any of the VAWA protections. Distribution or
issuance of this form does not serve as a written request for certification.
Confidentiality: All information provided to your housing provider concerning the incident(s) of
domestic violence, dating violence, sexual assault, or stalking shall be kept confidential and such details
shall not be entered into any shared database. Employees of your housing provider are not to have access
to these details unless to grant or deny VAWA protections to you, and such employees may not disclose
this information to any other entity or individual, except to the extent that disclosure is: (i) consented to
by you in writing in a time-limited release; (ii) required for use in an eviction proceeding or hearing
regarding termination of assistance; or (iii) otherwise required by applicable law
Form HUD-5382
( 12016)
TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC VIOLENCE,
ATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
1. Date the writfen request is received by victim:
2. Name of victim:
3 Your name (if different from victim’s): i
4. Name(s) of other family member(s) listed on the lease: sci
Residence of victim:
Name of the accused perpetrator (if known and can be safely disclosed):
epee
Relationship of the accused perpetrator fo the victim: a
8. Date(s) and times(s) of incident(s) (if known): er
10. Location of incident(s):
In your own words, briefly describe the incident(s):
This is to certify that the information provided on this form is true and correct to the best of my
knowledge and recollection, and that the individual named above in Item 2 is or has been a victim of
domestic violence, dating violence, sexual assault, or stalking. 1 acknowledge that submission of false
information could jeopardize program eligibility and could be the basis for denial of admission,
termination of assistance, or eviction.
Signature Signed on (Date)
Public Reporting Burden: The public reporting burden for this collection of information is estimated to
average | hour per response. This includes the time for collecting, reviewing, and reporting the data. The
information provided is to be used by the housing provider to request certification that the applicant or
tenant is a victim of domestic violence, dating violence, sexual assault, or stalking. The information is
subject to the confidentiality requirements of VAWA. This agency may not collect this information, and
you are not required to complete this form, unless it displays a currently valid Office of Management and
Budget control number.
Form HUD-5382
(12/2016)
CERTIFICATION OF U.S. Department of Housing OMB Approval No. 2577
5 -0286
DOMESTIC VIOLENCE, and Urban Development
Exp. 06/30/2017
DATING VIOLENCE,
SEXUAL ASSAULT, OR STALKING,
AND ALTERNATE DOCUMENTATION
Purpose of Form: The Violence Against Women Act (“VAWA”) protects applicants,
tenants, and
program participants in certain HUD programs from being evicted, denied housing assistance
, or
terminated from housing assistance based on acts of domestic violence, dating violence,
sexual assault, or
stalking against them. Despite the name of this law, VAWA protection is available to v icti
ms of domestic
violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity,
or sexual
orientation,
Use of This Optional Form: If you are seeking VAWA protections from your housing provider,
your
housing provider may give you a written request that asks you to submit documentation about the incident
or incidents of domestic violence, dating violence, sexual assault, or stalking.
In response to this request, you or someone on your behalf may complete this optional form
and submit it
to your housing provider, or you may submit one of the following types of third-party document
ation
(1) A document signed by you and an employee, agent, or volunteer ofa
victim service provider, an
attorney, or medical professional, or a mental health professional (collectively, “professio
nal”) from
whom you have sought assistance relating to domestic violence, dating violence,
sexual assaul lt, or
stalking, or the effects of abuse. The document must specify, under penalty of perjury, that th
e
professional believes the incident or incidents of domestic violence, datin. g Violence,
sexual assault, or
stalking occurred and meet the definition of “domestic violence,” “dating violence,” “ ‘sexual
assault,” or
“stalking” in HUD’s regulations at 24 CFR 5.2003.
(2) A record ofa Federal, State, tribal, territorial or local law enforcement agency, court, or
administrative agency; or
(3) At the discretion of the housing provider, a staternent or other evidence provided by
the appl icant or
tenant,
Submission of Documentation: The time period to submit documentation is 14 business
days fiom the
date that you receive a written request from your housing provider asking
that you provide documentation
of the occurrence of domestic violence, dating violence, sexual assault, or stalkin,
g- Your housing
provider may, but is not required to, extend the time period to submit the documentation,
if you request an
extension of tie time period, Ifthe requested information is not received within 14 business days
of when
you received the request for the documentation, or any extension of the date provided by
your housing
provider, your housing provider does not need to grant you any of the VAW.‘A protection
s. Distribution or
issuance of this form does not serve as a written request for certification,
Confidentiality: All information provided to your housing provider concerning the incident(s)
of
domestic violence, dating violence, sexual assault, or stalking shall be kept confident
ial and such details
shall not be entered into any shared database. Employees of your housing provider
are not to have access
to these details unless to grant or deny VAWA protections to you, and such
employees may not disclose
this information to any other entity or individual, except to the extent that disclosure is: (i) con
sented to
by you in writing in a time-limited release; (ii) required for use in an eviction proceeding or heari
ng
regarding termination of assistance; or (iii) otherwise required by applicable law.
Forrn HUD-5332
(12/2016)
TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF
DOMESTIC VIOLENCE
DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING
1 Date the written request is received by victim:
eee
2,2 Name of victim:
Your name (if different from victim’s): eee
Name(s) of other family member(s) listed on the lease:
pe
Residence of victim:
Name of the accused perpetrator (if known and can be safely disclosed):
Relationship of the accused perpetrator to the victim:
oe
Date(s) and times(s) of incident(s) (if known): a
10. Location ofincident(s):
In your own words, briefly describe the incident(s)
This is to certify that the information provided on this form is true and corre
ct to the best of my
knowledge and recollection, and that the individual named above in Item 2 is or has
been a victim of
domestic violence, dating violence, sexual assault, or stalking, I acknowledge that t subm
ission of false
information could jeopardize program eligibility and could be the basis for denial
of admission,
termination of assistance, or eviction.
Signature Signed on (Date)
Public Reporting Burden: The public reporting burden for this collectio
n of information is estimated to
average | hour per response. This includes the time for collecting, reviewing, and repor
ting the data. The
information pro vided is to be used by the housing provider to request certifica
tion that the applicant or
tenant is a vict of irn
domestic violence, dating violence, sexual assault, or stalking. The informat
ion is
subject to the confidentiality requirements of VAWA. This agency may not
collect this information, and
you are not required to complete this form, unless it displays a currently valid Office of Manageme
nt and
Budget control number.
‘
Form HUD-5382
(12/2016)
Preview
NOTICE TO QUIT POSSESSION TO TIARA COBB JANE DOE 31 Jaidee Drive East Hartford, Connecticut This is to give you notice that you are to quit possession of the premises known as: 31 Jaidee Drive, East Hartford, Connecticut now occupied by you on or before the 11t® day of January 2024 This notice is given for the following reason: TERMINATION OF LEASE DUE TO NONPAYMENT OF RENT and YOU NEVER HAD THE RIGHT OR PRIVILEGE TO OCCUPY THE PREMISES Notice is hereby given that effective this date any tender of money for rent shall be accepted by the Landlord for Use and Occupancy only. Dated at Hartford, Connecticut this 4th day of December 2023 aS, HX? QO Elliot J. 1-36 Jaidee RSD Rsq., Attorney e Associates LP for Enclosure: HUD Form 5380 and HUD Form 5382 STATE OF CONNECTICUT: pen b, Co2z3 ss. East Hartford ?&e™ COUNTY OF HARTFORD THEN I MADE due and legal service of the foregoing Notice to 4 “a’true Quit Possession, HUD Form 5380 and HUD For 5382, and Notice to Tenants pursuant to Public Act 21-34, by leavi n and attested copy (with ) at the usual place of abode of the within named: Tiara Cobb, Jane Doe, 31 Jaidee Drive, East Hartford of said town ATTE LLIOT J. LANE ATTORNEY AT LAW Ww 111 OAK STREET Charles illey HARTFORD, CT 06106 aoe State Marshal (60) 525-7180 Hartford County JURIS #33123 CAVA (ea do)a] You are facing ihe The State of Connecticut created a Right to Counsel program (CT-RTC) (3 Lo loss of your home to provide free legal representation ie or housing subsidy. to income eligible tenants facing eviction or loss of housing subsidy. eae We are here to help The program began in a few communities on January 31, 2022 and will grow over time. ae} Fiat) tlie hai Le) Pe ery Gevelenis nies aYelt) ie Pritt Py ae eae zl Scale ewe ey itell {eis co) 34 a ONLINE LEGAL HELP Go 2-1-4, HELPLINE GUIDE AND FORM FILLER EVICTION PREVENTION FUND to ctlawhelp.org/eviction to Call 211 for information and Go to cteviction.guide to learn Check your eligibilityfor UniteCT’s learn about the eviction referrals for housing, utility, about the eviction process Eviction Prevention Fund by visiting process and howto respond and food assistance or go to and prepare court forms for unitectprescreen.formstack.com/ to eviction notices. 2Alctorg, your case. forms/eviction_prevention El estado de Connecticut ha creado Wale Cola) Usted esta en riesgo el programa “Derecho aun Abogado” = aed de perder su hogar o su subsidio de (CT-RTC, por sus siglas en inglés) con el fin de brindar representacién juridica egeie gratuita a inquilinos de bajos ingresos vivienda. Estamos que corran riesgo de desalojo o pérdida del subsidio de vivienda aqui para ayudarle El programa comenzé el 31 de enero de 2022 en un ntimero limitado de comunidades y continuard expandiéndose. Lele) er ne geil less eee to Pee} I leery Prete) cee ele ) Meer ie) Cx Ae ae ey Ga RIPE w ETC cl alee RTA} iy Pee MW ALLL 1 aY=4) [oot ee) @ 3 ASISTENCIA LEGAL LINEA DE ASISTENCIA 2-1-1 GUIA PARA COMPLETAR FONDO PREVENTIVO. POR INTERNET Para informacion y FORMULARIOS DEDESALOJOS Visite ctlawhelp.org/eviction derivacionesa programas Visite cteviction.guide para Para verificar si reine los para obtener informacién sobre de asistencia con el alquiler, obtener informacién sobre el requisitos para recibir asistencia el proceso de desalojo y como servicios puiblicosy alimentos, proceso de desalojo y cémo. del Fondo Preventivo de respondera una notificacién llame al 211 or visite 211ct.org, completar los farmularios Desalojos de UniteCT, visite de desalo} judiciales. unitectprescreen.formstack.com/ forms/eviction_prevention 114 Ti 13 a a portent ee Grate By ey ee (e113 CIC eg My 5 te} MA Le laf ie Revised 2/24/2023 NOTICE OF OCCUPANCY RIGHTS UNDER U.S. Department of Housing and Urban Development THE VIOLENCE AGAINST WOMEN ACT OMB Approval No. 2577-0286 Expires 06/30/2017 EASTON PLACE APARTMENTS Notice of Occupancy Rights under the Violence Against Women Act! To all Tenants and Applicants The Violence Against Women Act (VAWA) provides protections for victims of domestic violence, dating violence, sexual assault, or stalking. VAWA protections are not only available to women, but are available equally to all individuals regardless of sex, gender identity, or sexual orientation.* The U.S. Department of Housing and Urban Development (HUD) is the Federal agency that oversees that Low Income Housing Tax Credit (LIHTC) Program is in compliance with VAWA. This notice explains your rights under VAWA. A HUD-approved certification form is attached to this notice. You can fill out this form to show that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking, and that you wish to use your rights under VAWA.” Protections for Applicants Tf you otherwise qualify for assistance under Low Income Housing Tax Credit (LIMTC) Program, you cannot be denied admission or denied assistance because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Protections for Tenants If you are receiving assistance under Low Income Housing Tax Credit (LIHTC) Program, you may not be denied assistance, terminated from participation, or be evicted from your rental ' Despite the name of this law, VAWA protection is available regardless of sex, gender identity, or sexual orientation. * Housing providers cannot discriminate on the basis of any protected characteristic, including race, color, national origin, religion, scx, familial status, disability, or age. HUD-assisted and HUD-insured housing must be made available to all otherwise cligible individuals regardless of actual or perceived sexual orientation, gender identity, or marital status. Form HUD-5380 (12/2016) housing because you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Also, if you or an affiliated individual of yours is or has been the victim of domestic violence, dating violence, sexual assault, or stalking by a member of your houschold or any guest, you may not be denied rental assistance or occupancy rights under Low Income Housing Tax Credit (LIHTC) Program solely on the basis of criminal activity directly relating to that domestic violence, dating violence, sexual assault, or stalking. Affiliated individual means your spouse, parent, brother, sister, or child, or a person to whom you stand in the place of a parent or guardian (for example, the affiliated individual is in your care, custody, or control); or any individual, tenant, or lawful occupant living in your household. Removing the Abuser or Perpetrator from the Household HP may divide (bifurcate) your lease in order to evict the individual or terminate the assistance of the individual who has engaged in criminal activity (the abuser or perpetrator) directly relating to domestic violence, dating violence, sexual assault, or stalking. If HP chooses to remove the abuser or perpetrator, HP may not take away the rights of eligible tenants to the unit or otherwise punish the remaining tenants. If the evicted abuser or perpetrator was the sole tenant to have established eligibility for assistance under the program, HP must allow the tenant who is or has been a victim and other household members to remain in the unit for a period of time, in order to establish eligibility under the program or under another HUD housing program covered by VAWA, or, find alternative housing. In removing the abuser or perpetrator from the household, HP must follow Federal, State, and local eviction procedures. In order to divide a lease, HP may, but is not required to, ask you for Form HUD-5380 (12/2016) documentation or certification of the incidences of domestic violence, dating violence, sexual assault, or stalking. Moving to Another Unit Upon your request, HP may permit you to move to another unit, subject to the availability of other units, and still keep your assistance. In order to approve a request, HP may ask you to provide documentation that you are requesting to move because of an incidence of domestic violence, dating violence, sexual assault, or stalking. If the request is a request for emergency transfer, the housing provider may ask you to submit a written request or fill out a form where you certify that you meet the criteria for an emergency transfer under VAWA. The criteria are: (1) You are a victim of domestic violence, dating violence, sexual assault, or stalking. If your housing provider does not already have documentation that you are a victim of domestic violence, dating violence, sexual assault, or stalking, your housing provider may ask you for such documentation, as described in the documentation section below. (2) You expressly request the emergency transfer. Your housing provider may choose to require that you submit a form, or may accept another written or oral request. (3) You reasonably believe you are threatened with imminent harm from further violence if you remain in your current unit. This means you have a reason to fear that if you do not receive a transfer you would suffer violence in the very near future. OR Form HUD-5380 in (24 2 016) You are a victim of sexual assault and the assault occurred on the premises during the 90-calendar-day period before you request a transfer. If you are a victim of sexual assault, then in addition to qualifying for an emergency transfer because you reasonably believe you are threatened with imminent harm from further violence if you remain in your unit, you may qualify for an emergency transfer if the sexual assault occurred on the premises of the property from which you are seeking your transfer, and that assault happened within the 90-calendar- day period before you expressly request the transfer. HP will keep confidential requests for emergency transfers by victims of domestic violence, dating violence, sexual assault, or stalking, and the location of any move by such victims and their families. HP’s emergency transfer plan provides further information on emergency transfers, and HP must make a copy of its emergency transfer plan available to you if you ask to see it. Documenting You Are or Have Been a Victim of Domestic Violence, Dating Violence, Sexual Assault or Stalking HP can, but is not required to, ask you to provide documentation to “certify” that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. Such request from HP must be in writing, and HP must give you at least 14 business days (Saturdays, Sundays, and Federal holidays do not count) from the day you receive the request to provide the documentation. HP may, but does not have to, extend the deadline for the submission of documentation upon your request. Form HUD-5380 (12/2016) You can provide one of the following to HP as documentation. It is your choice which of the following to submit if HP asks you to provide documentation that you are or have been a victim of domestic violence, dating violence, sexual assault, or stalking. ° A complete HUD-approved certification form given to you by HP with this notice, that documents an incident of domestic violence, dating violence, sexual assault, or stalking. The form will ask for your name, the date, time, and location of the incident of domestic violence, dating violence, sexual assault, or stalking, and a description of the incident. The certification form provides for including the name of the abuser or perpetrator if the name of the abuser or perpetrator is known and is safe to provide. A record of a Federal, State, tribal, territorial, or local law enforcement agency, court, or administrative agency that documents the incident of domestic violence, dating violence, sexual assault, or stalking. Examples of such records include police reports, protective orders, and restraining orders, among others. A statement, which you must sign, along with the signature of an employee, agent, or volunteer of a victim service provider, an attorney, a medical professional or a mental health professional (collectively, “professional”) from whom you sought assistance in addressing domestic violence, dating violence, sexual assault, or stalking, or the effects of abuse, and with the professional selected by you attesting under penalty of perjury that he or she believes that the incident or incidents of domestic violence, dating violence, sexual assault, or stalking are grounds for protection. Any other statement or evidence that HP has agreed to accept. If you fail or refuse to provide one of these documents within the 14 business days, HP does not have to provide you with the protections contained in this notice. Form HUD-5380 (12/2016) 6 If HP receives conflicting evidence that an incident of domestic violence, dating violence, sexual assault, or stalking has been conmnitted (such as certification forms from two or more members ofa houschold each claiming to be a victim and naming one or more of the other petitioning household members as the abuser or perpetrator), HP has the right to request that you provide third-party documentation within thirty 30 calendar days in order to resolve the conflict. If you fail or refuse to provide third-party documentation where there is conflicting evidence, HP does not have to provide you with the protections contained in this notice. Confidentiality HP must keep confidential any information you provide related to the exercise of your rights under VAWA, including the fact that you are exercising your rights under VAWA. HP must not allow any individual administering assistance or other services on behalf of HP (for example, employees and contractors) to have access to confidential information unless for reasons that specifically call for these individuals to have access to this information under applicable Federal, State, or local law. HP must not enter your information into any shared database or disclose your information to any other entity or individual. HP, however, may disclose the information provided ift You give written permission to HP to release the information on a time limited basis. HP needs to use the information in an eviction or termination proceeding, such as to evict your abuser or perpetrator or terminate your abuser or perpetrator from assistance under this program, A law requires HP or your landlord to release the information. Form HUD-5380. (12/2016) VAWA does not limit HP’s duty to honor court orders about access to or control of the property. This includes orders issued to protect a victim and orders dividing property among household members in cases where a family breaks up. Reasons a Tenant Eligible for Occupancy Rights under VAWA May Be Evicted or Assistance May Be Terminated You can be evicted and your assistance can be terminated for serious or repeated lease violations that are not related to domestic violence, dating violence, sexual assault, or stalking committed against you. However, HP cannot hold tenants who have been victims of domestic violence, dating violence, sexual assault, or stalking to a more demanding set of rules than it applies to tenants who have not been victims of domestic violence, dating violence, sexual assault, or stalking. The protections described in this notice might not apply, and you could be evicted and your assistance terminated, if HP can demonstrate that not evicting you or terminating your assistance would present a real physical danger that: 1) Would occur within an immediate time frame, and 2) Could result in death or serious bodily harm to other tenants or those who work on the property. If HP can demonstrate the above, HP should only terminate your assistance or evict you if there are no other actions that could be taken to reduce or eliminate the threat. Other Laws VAWA does not replace any Federal, State, or local law that provides greater protection for victims of domestic violence, dating violence, sexual assault, or stalking. You may be entitled to Form HUD-5380 (12/2016) 8 additional housing protections for victims of domestic violence, dating violence, sexual assault, or stalking under other Federal laws, as well as under State and local laws. Non-Compliance with The Requirements of This Notice You may report a covered housing provider’s violations of these rights and seek additional assistance, if needed, by contacting or filing a complaint with Connecticut Housing Finance Authority (CHFA) 999 West Street, Rocky Hill, CT 06067 (860) 721-9501. For Additional Information ‘You may view a copy of HUD’s final VAWA rule at https://www.federalregister.gov/documents/2016/11/16/2016-25888/violence-against-women- reauthorization-act-of-2013-implementation-in-hud-housing-prog Se Additionally, HP must make a copy of HUD’s VAWA regulations available to you if you ask to see them. For questions regarding VAWA, please contact Frank Stellato 860-838-4899. For help regarding an abusive relationship, you may call the National Domestic Violence Hotline at 1-800-799-7233 or, for persons with hearing impairments, 1-800-787-3224 (TTY). You may also contact Domestic Violence Services of Meriden at (203) 238-1501. For tenants who are or have been victims of stalking seeking help may visit the National Center for Victims of Crime’s Stalking Resource Center at https:/Avww.victimsofcrime.org/our- programs/stalking-resource-center. For help regarding sexual assault, you may contact The Women and Families Center, Meriden Hotlne at (203) 235-4444, Victims of stalking seeking help may contact VictimConnect/National Hotline for Crime Victims (855) 484-2846, Attachment: Certification form HUD-5382 Form HUD-5380 (12/2016) CERTIFICATION OF -S. Department of Housing OMB Approval No. 2577-0286 DOMESTIC VIOLENCE, and Urban Development Exp. 06/ 3 0: 2017 DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING, AND ALTERNATE DOCUMENTATION Purpose of Form: The Violence Against Women Act (“VAWA”) protects applicants, tenants, and program participants in certain HUD programs from being evicted, denied housing assistance, or terminated from housing assistance based on acts of domestic violence, dating violence, sexual assault, or stalking against them. Despite the name of this law, VAWA protection is available to victims of domestic violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity, or sexual orientation. Use of This Optional Form: If you are seeking VAWA protections from your housing provider, your housing provider may give you a written request that asks you to submit documentation about the incident or incidents of domestic violence, dating violence, sexual assault, or stalking, In response to this request, you or someone on your behalf may complete this optional form and submit it to your housing provider, or you may submit one of the following types of third-party documentation: (1) A document signed by you and an employee, agent, or volunteer of a victim service provider, an attorney, or medical professional, or a mental health professional (collectively, “professional”) from whom you have sought assistance relating to domestic violence, dating violence, sexual assault, or stalking, or the effects of abuse. The document must specify, under penalty of perjury, that the professional believes the incident or incidents of domestic violence, dating violence, sexual assault, or stalking occurred and meet the definition of “domestic violence,” “dating violence,” “sexual assault,” or “stalking” in HUD’s regulations at 24 CFR 5.2003 (2) A record ofa Federal, State, tribal, territorial or local law enforcement agency, court, or administrative agency; or (3) At the discretion of the housing provider, a statement or other evidence provided by the applicant or tenant. Submission of Documentation: The time period to submit documentation is 14 business days from the date that you receive a written request from your housing provider asking that you provide documentation of the occurrence of domestic violence, dating violence, sexual assault, or stalking. Your housing provider may, but is not required to, extend the time period to submit the documentation, if you request an extension of the time period. If the requested information is not received within 14 business days of when you received the request for the documentation, or any extension of the date provided by your housing provider, your housing provider does not need to grant you any of the VAWA protections. Distribution or issuance of this form does not serve as a written request for certification. Confidentiality: All information provided to your housing provider concerning the incident(s) of domestic violence, dating violence, sexual assault, or stalking shall be kept confidential and such details shall not be entered into any shared database. Employees of your housing provider are not to have access to these details unless to grant or deny VAWA protections to you, and such employees may not disclose this information to any other entity or individual, except to the extent that disclosure is: (i) consented to by you in writing in a time-limited release; (ii) required for use in an eviction proceeding or hearing regarding termination of assistance; or (iii) otherwise required by applicable law Form HUD-5382 ( 12016) TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC VIOLENCE, ATING VIOLENCE, SEXUAL ASSAULT, OR STALKING 1. Date the writfen request is received by victim: 2. Name of victim: 3 Your name (if different from victim’s): i 4. Name(s) of other family member(s) listed on the lease: sci Residence of victim: Name of the accused perpetrator (if known and can be safely disclosed): epee Relationship of the accused perpetrator fo the victim: a 8. Date(s) and times(s) of incident(s) (if known): er 10. Location of incident(s): In your own words, briefly describe the incident(s): This is to certify that the information provided on this form is true and correct to the best of my knowledge and recollection, and that the individual named above in Item 2 is or has been a victim of domestic violence, dating violence, sexual assault, or stalking. 1 acknowledge that submission of false information could jeopardize program eligibility and could be the basis for denial of admission, termination of assistance, or eviction. Signature Signed on (Date) Public Reporting Burden: The public reporting burden for this collection of information is estimated to average | hour per response. This includes the time for collecting, reviewing, and reporting the data. The information provided is to be used by the housing provider to request certification that the applicant or tenant is a victim of domestic violence, dating violence, sexual assault, or stalking. The information is subject to the confidentiality requirements of VAWA. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid Office of Management and Budget control number. Form HUD-5382 (12/2016) CERTIFICATION OF U.S. Department of Housing OMB Approval No. 2577 5 -0286 DOMESTIC VIOLENCE, and Urban Development Exp. 06/30/2017 DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING, AND ALTERNATE DOCUMENTATION Purpose of Form: The Violence Against Women Act (“VAWA”) protects applicants, tenants, and program participants in certain HUD programs from being evicted, denied housing assistance , or terminated from housing assistance based on acts of domestic violence, dating violence, sexual assault, or stalking against them. Despite the name of this law, VAWA protection is available to v icti ms of domestic violence, dating violence, sexual assault, and stalking, regardless of sex, gender identity, or sexual orientation, Use of This Optional Form: If you are seeking VAWA protections from your housing provider, your housing provider may give you a written request that asks you to submit documentation about the incident or incidents of domestic violence, dating violence, sexual assault, or stalking. In response to this request, you or someone on your behalf may complete this optional form and submit it to your housing provider, or you may submit one of the following types of third-party document ation (1) A document signed by you and an employee, agent, or volunteer ofa victim service provider, an attorney, or medical professional, or a mental health professional (collectively, “professio nal”) from whom you have sought assistance relating to domestic violence, dating violence, sexual assaul lt, or stalking, or the effects of abuse. The document must specify, under penalty of perjury, that th e professional believes the incident or incidents of domestic violence, datin. g Violence, sexual assault, or stalking occurred and meet the definition of “domestic violence,” “dating violence,” “ ‘sexual assault,” or “stalking” in HUD’s regulations at 24 CFR 5.2003. (2) A record ofa Federal, State, tribal, territorial or local law enforcement agency, court, or administrative agency; or (3) At the discretion of the housing provider, a staternent or other evidence provided by the appl icant or tenant, Submission of Documentation: The time period to submit documentation is 14 business days fiom the date that you receive a written request from your housing provider asking that you provide documentation of the occurrence of domestic violence, dating violence, sexual assault, or stalkin, g- Your housing provider may, but is not required to, extend the time period to submit the documentation, if you request an extension of tie time period, Ifthe requested information is not received within 14 business days of when you received the request for the documentation, or any extension of the date provided by your housing provider, your housing provider does not need to grant you any of the VAW.‘A protection s. Distribution or issuance of this form does not serve as a written request for certification, Confidentiality: All information provided to your housing provider concerning the incident(s) of domestic violence, dating violence, sexual assault, or stalking shall be kept confident ial and such details shall not be entered into any shared database. Employees of your housing provider are not to have access to these details unless to grant or deny VAWA protections to you, and such employees may not disclose this information to any other entity or individual, except to the extent that disclosure is: (i) con sented to by you in writing in a time-limited release; (ii) required for use in an eviction proceeding or heari ng regarding termination of assistance; or (iii) otherwise required by applicable law. Forrn HUD-5332 (12/2016) TO BE COMPLETED BY OR ON BEHALF OF THE VICTIM OF DOMESTIC VIOLENCE DATING VIOLENCE, SEXUAL ASSAULT, OR STALKING 1 Date the written request is received by victim: eee 2,2 Name of victim: Your name (if different from victim’s): eee Name(s) of other family member(s) listed on the lease: pe Residence of victim: Name of the accused perpetrator (if known and can be safely disclosed): Relationship of the accused perpetrator to the victim: oe Date(s) and times(s) of incident(s) (if known): a 10. Location ofincident(s): In your own words, briefly describe the incident(s) This is to certify that the information provided on this form is true and corre ct to the best of my knowledge and recollection, and that the individual named above in Item 2 is or has been a victim of domestic violence, dating violence, sexual assault, or stalking, I acknowledge that t subm ission of false information could jeopardize program eligibility and could be the basis for denial of admission, termination of assistance, or eviction. Signature Signed on (Date) Public Reporting Burden: The public reporting burden for this collectio n of information is estimated to average | hour per response. This includes the time for collecting, reviewing, and repor ting the data. The information pro vided is to be used by the housing provider to request certifica tion that the applicant or tenant is a vict of irn domestic violence, dating violence, sexual assault, or stalking. The informat ion is subject to the confidentiality requirements of VAWA. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid Office of Manageme nt and Budget control number. ‘ Form HUD-5382 (12/2016)