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TO Priscilla Rosa
150 Nelson Street, Unit # 6
Hartford, CT 06112
PLEASE TAKE NOTICE that you are to QUIT POSSESSION and occupancy of the
premises now occupied by you, consisting of 150 Nelson Street, Unit # 6, Hartford, CT 06112
on or before February 14, 2024, pursuant to the statute in such cases made and provided, for
the following reasons:
1. Non-payment of Rent.
ANY PAYMENTS TENDERED AFTER SERVICE OF THE NOTICE TO QUIT
WILL BE ACCEPTED FOR REIMBURSEMENT OF COSTS AND FOR USE
AND OCCUPANCY ONLY, AND NOT FOR RENT, WITH FULL RESERVATION
OF RIGHTS TO CONTINUE WITH THE EVICTION ACTION.
DATED at Milford, Connecticut, this day, Wednesday, January 10, 2024.
Northeast Hartford Affor ble Housing Limited
Partnership
By
obert W. Chesson, Esq.
G. Adam Schweickert, Esq.
Jeff M. Mastrianni, Esq.
Chesson & Schweickert LLC
215 Broad Street
Milford, CT 06460
Tel.: 203-874-4747
Juris No. 423788
THEIR ATTORNEY
3671-0007
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
Northeast Hartford Affordable Housing Limited Partnership (Housing
Pro r, or “HP”)'
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 your rental assistance program(s)‘ 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
' The notice uses HP for housing provider but the housing provider should insert its name where HP is used.
HUD’s program-specific regulations identify the individual or entity responsible for providing the notice of
occupancy rights.
2 Despite the name of this law, VAWA protection is available regardless of sex, gender identity, or sexual
orientation.
3 Housing providers cannot discriminate on the basis of any protected characteristic, including race, color, national
origin, religion, sex, familial status, disability, or age. HUD-assisted and HUD-insured housing must be made
available to all otherwise eligible individuals regardless of actual or perceived sexual orientation, gender identity, or
marital status.
+ Applicable rental assistance program(s) may include, but are not limited to:
Section 202 Supportive Housing for the Elderly
Section 811 Supportive Housing for Persons with Disabilities
Housing Opportunities for Persons With AIDS (HOPWA) program
Homeless programs under title [V of the McKinney-Vento Homeless Assistance Act
HOME Investment Partnerships (HOME) program
BMIR - Section 221(d)(3) and (5) Below Market Interest Rate Housing
Section 236 Multifamily Rental Housing
Public Housing
Section 8 Housing Choice Voucher Program
Project-Based Section 8 Housing
Housing Trust Fund
Rural Development Multifamily Housing Programs
Low Income Housing Tax Credit Program
USDA Section 514 and 516 Farm Labor Housing
USDA Section 515 Rental Housing
USDA Section 533 Housing Preservation Grant Program
Other Federal housing programs that provide affordable housing to low and moderate-income persons
through restricted rents or rental assistance, or other affordable housing opportunities, which HUD
identifies as covered by VAWA
Form HUD-53801
(12/2016)
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
If you otherwise qualify for assistance under your rental assistance program(s), 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 your rental assistance program(s), you may not be denied assistance,
terminated from participation, or be evicted from your rental 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 household or any guest, you may not be denied rental assistance or
occupancy rights under your rental assistance program(s) 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
ofa 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
eligi lity 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.
Form HUD-53802
(12/2016)
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
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 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
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 area
Form HUD-53803
(12/2016)
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
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.
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,
Form HUD-53804
(12/2016)
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
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.
If HP receives conflicting evidence that an incident of domestic violence, dating violence, sexual assault, or stalking
has been committed (such as certification forms from two or more members of a household 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.
Form HUD-53805
(12/2016)
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
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 if:
. 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.
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.
Form HUD-53806
(12/2016)
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
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 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:
U.S. Department of Housing and Urban Development
Multifamily Northeast Region
Hartford Field Office
20 Church Street, 10 Floor
Hartford, CT 06103-3220
Phone: (860) 240-4800
For Additional Information
You may view a copy of HUD’s final VAWA tule at https://www. federalregister.gov/documents/20
16/1 1/16/2016-
25888/violence-against-women-reauthorization-act-of-2013-implementation-in-hud-housing-programs.
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:
Agent for Northeast Hartford Affordable Housing Limited Partnership
54 S Prospect Street, Hartford, CT 06106
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 Safe Futures at (860) 701-
6000, or 2-1-1* for additional resources by dialing 211 or visiting them on the web at http://www.21 l.org.
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://www.victimsofcrime.org/our-programs/stalking-resource-center.
For help regarding sexual assault, you may contact CT Sexual Assault Crisis Services at (860) 281-9881, local law
enforcement, or 2-1-1* for additional resources by dialing 211 or visiting them on the web at http://www.211.org.
Form HUD-53807
(12/2016)
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
Victims of stalking seeking help may contact local law enforcement, or 2-1-1* for additional resources by dialing
211 or visiting them on the web at hup:/www.21Lorg.
Attachment: Certification form HUD-5382 - Certification of Domestic Violence, Dating Violence, Sexual Assault,
or Stalking, and Alternate Documentation
Form HUD-53808
(12/2016)
CERTIFICATION OF U.S. Department of Housing OMB Approval No. 2577-0286
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 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,
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, 1 ‘sexual assault,” or
“stalking” in HUD’s regulations at 24 CFR 5.2003.
(2) A record of a 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
(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:
2 Name of victim:
Your name (if different from victim’s):
Name(s) of other family member(s) listed on the lease:
Residence of victim:
Name of the accused perpetrator (if known and can be safely disclosed):
Relationship of the accused perpetrator to the victim:
Date(s) and times(s) of incident(s) (if known):
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. I 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)
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