Colorado Housing Relief Application

Section 1: Personal Information

Please provide your legal name exactly as it appears on your Colorado State ID.

First Name

Middle Name

Last Name

Date of Birth

Gender

Email Address

Primary Phone Number

Section 2: Colorado Residency Verification

Verify your current living situation in Colorado.

Current Street Address

Apartment/Suite Number (if applicable)

City

Zip Code

How long have you resided at this address?

Housing Type

Monthly Housing Cost (Rent or Mortgage Payment)

Section 3: Identity Verification

State law requires identity verification to prevent fraud. All information must match your Colorado State ID.

Colorado State ID or Driver's License Number

ID Expiration Date

Social Security Number (SSN)

Upload Front of Colorado ID/Driver's License

Choose File

Accepted formats: JPG, PNG, PDF (Max 5MB)

Upload Back of Colorado ID/Driver's License

Choose File

Accepted formats: JPG, PNG, PDF (Max 5MB)

Section 4: Employment Information

Provide details of your current or most recent employment.

Current Employment Status

Name of Last Employer/Company

Job Title/Position at Last Employer

Company Street Address

Company City & State

Company Zip Code

Approximate Annual Income from Last Job

Section 5: Program Eligibility

Final verification steps.

Have you previously applied for Colorado Housing Relief?

Do you consent to the state sharing your SSN with the Federal Housing Database for verification?

How did you hear about this program?

Additional Comments or Special Circumstances

Section 6: Certification & Submission

Certification: By submitting this application, you certify that all information provided is true and accurate. You understand that providing false information may result in denial of benefits and potential legal consequences under Colorado Revised Statutes C.R.S. § 26-1-127.

I certify that the information provided is true and correct to the best of my knowledge.