2.2.1 Attachment 7 - DR-4832-TN Temporary Housing Agreement.pdf

FEMA Form FF-104-FY-21-194 (formerly 009-0-135) (7/22)

Initials of Applicant

DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency

FEMA Registration #: FEMA DR #:

Applicant's Name: Date of Declaration:

THU Address:

Description of Property

# of Bedrooms: # of Baths: Other (specify):

I acknowledge that FEMA is permitting me, as the Licensee, to use the above THU for direct temporary housing because: the President has declared a major disaster or emergency for my state, tribe, or territory and direct temporary housing assistance is authorized in my county/ jurisdiction; I am not able to live in my household's pre-disaster primary residence or obtain adequate alternate housing through no fault of my own due to this event; and FEMA has determined my household to be eligible for direct temporary housing assistance under Section 408 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. § 5174(c)(1)(B) and FEMA regulations at 44 C.F.R. §§ 206.110-118. If not revoked earlier, this license will automatically expire 18 months from the date of the President's declaration of a major disaster or emergency or at the end of any extension to the 18-month period of assistance granted under 42 U.S.C. § 5174(c)(1)(B)(iii).

I acknowledge receiving keys to the above-described THU for use as temporary housing for my household only.

AUTHORIZED USERS IN HOUSEHOLD

Name Relationship to Applicant Age Sex

PAPERWORK BURDEN DISCLOSURE NOTICE

Public reporting burden for this form is estimated to average 15 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form.

This collection of information is mandatory. You are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC, 20472, Paperwork Reduction Project (1660-0138). Please do not send your completed survey to the above address.

OMB Control Number: 1660-0138 Expiration Date: 7/31/2025

PRIVACY ACT STATEMENT

AUTHORITY: The Robert T. Stafford Disaster Relief and Emergency Assistance Act as amended, 42 U.S.C. § 5174 and Title 44 C.F.R. Part 206.117.

PRINCIPAL PURPOSE(S): This information is being collected for the primary purpose of notifying eligible applicants of the requirements for occupying a Temporary Housing Unit (THU) and potential fees as part of direct temporary housing assistance under a Presidentially-declared disaster.

ROUTINE USE(S): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by the routine uses published in DHS/FEMA - 008 Disaster Recovery Assistance Files System of Records, 78 Fed. Reg. 25282 (Apr. 30, 2013), and upon written request, by agreement, or as required by law.

DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent the applicant from receiving the requested disaster-related temporary housing assistance.

DIRECT TEMPORARY HOUSING ASSISTANCE

TEMPORARY HOUSING AGREEMENT

Initials of Applicant

AGREEMENT OF TERMS AND FEMA REGULATIONS & POLICIES

FEMA has entered into a contract with (hereinafter "Landlord") to provide temporary housing assistance to displaced disaster Applicants through the Multi-Family Lease and Repair Program (MLRP) or Direct Lease, authorized under Sections 408(c) (1)(B)(ii) and 502(a)(6) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act). FEMA is providing the THU as a discretionary benefit under 42 U.S.C. § 5174 and 44 C.F.R. §§ 206.110-118. As a condition of occupancy, the Applicant is required to execute this Temporary Housing Agreement and a landlord-tenant Lease (hereinafter “Lease”) with the Landlord along with the required FEMA Lease addendum.

1. TERM OF OCCUPANCY. The term shall begin on and shall continue until:

a. The Lease is terminated by the Landlord in accordance with applicable state and local Tenant/Landlord laws;

b. the Lease is terminated by the Applicant in accordance with the Lease or by mutual agreement during the term of the Lease;

c. a determination by FEMA that the Applicant is no longer eligible;

d. the period of assistance ends, unless extended. The current period of assistance ends on

2. HOUSEHOLD MEMBERS. The Applicant may not permit other persons to live in the THU not named in this agreement without FEMA approval.

3. APPLICANT COMPLIANCE. Maintaining this Agreement to use the THU is based on the Applicant remaining eligible for continued direct temporary housing assistance and complying with the terms of this agreement, and any other rules provided and incorporated in this agreement.

4. FEMA CONTINUING ELIGIBILITY REQUIREMENTS. FEMA requires all recipients of direct temporary housing assistance to provide documentation showing that they are making diligent efforts to obtain permanent housing and to obey all applicable Federal, State, and local laws while occupying temporary housing units provided by FEMA. FEMA requires the Applicant to establish and work towards a realistic permanent housing plan and comply with any landlord-tenant rules for the unit. Eligibility requirements for and regulations governing direct temporary housing assistance are set forth at 44 C.F.R. §§ 206.110-118. If FEMA determines these requirements have not been met, the agreement to occupy the THU will be revoked and a written Notice of Revocation will be issued requiring the Applicant's household to vacate the THU, remove all personal property, and return the THU keys to the Owner no later than the date established in the Notice of Revocation.

5. APPLICANT DUTY TO OBTAIN/ACCEPT ALTERNATE HOUSING. FEMA requires all recipients of temporary housing assistance to obtain and occupy adequate alternate housing at the earliest possible time. The Applicant will establish a permanent housing plan and make every effort to obtain permanent housing for the Applicant's household as soon as possible. If FEMA determines that adequate alternate housing is available, the Applicant will obtain alternate housing and vacate the THU as soon as possible. Refusal to accept adequate alternate housing resources offered by FEMA can result in revocation of this agreement to occupy the THU. If FEMA determines that the Applicant has failed to diligently seek and obtain adequate alternate housing or to accept such housing resources presented, a written Notice of Revocation will be issued requiring the Applicant's household to vacate the THU, remove all personal property, and return the THU keys to the Landlord within the timeframe established in the Notice of Revocation.

6. RENT PAYMENTS. The Applicant will not pay a rental fee to the Landlord or FEMA during the period of assistance ending on

7. SECURITY DEPOSIT. FEMA will provide a security deposit amount established by contract between FEMA and the Landlord on behalf of the tenant. The Landlord may use the security deposit for any damage above normal wear and tear caused by the Applicant to the THU. In the event the security deposit amount does not cover the amount of damage to the THU, the Applicant will be responsible to the Landlord for the additional funds. During the term of the Lease, the Landlord will not charge the Applicant an additional security deposit.

8. PET DEPOSITS. The Applicant is responsible for paying any pet security deposit to the Landlord as required by the Landlord. The Applicant shall abide by any pet policy required by the Landlord.

9. UTILITIES AND APPLIANCES. The Applicant is responsible for paying all utilities as specified in the Lease between the Landlord and Applicant. FEMA will pay utilities for the designated THUs only when the utilities are included in the FEMA contract with the Landlord.

10. MAINTENANCE AND OTHER SERVICES.

a. Property management, maintenance, and other Landlord-Tenant relationships will remain the responsibility of the Landlord.

b. The Applicant will direct any maintenance issues regarding the THU directly to the Landlord.

If FEMA extends the period of assistance beyond this date, FEMA will charge the Applicant rent for each month the occupies the rental THU, as described in Paragraph 17.

TEMPORARY HOUSING AGREEMENT continued

Initials of Applicant

11. APPLICANT PERSONAL PROPERTY. During the term of this agreement, the Applicant is responsible for their personal property in the unit and for obtaining any required personal property insurance.

12. FEMA ACCESS TO PROPERTY. A FEMA representative will contact the Applicant or household members to schedule regular appointments to review the Applicant's eligibility to continue occupying the unit and to assist in establishing a realistic permanent housing plan.

The Applicant must cooperate with FEMA representatives. This includes making the Applicant or household members available for regularly scheduled appointments, at which time the Applicant or household members will be expected to provide documentation, allow access to the unit and to the pre-disaster residence, if applicable, in order to demonstrate that progress is being made towards achieving a permanent housing plan and eligibility requirements for continued temporary housing assistance are being met. Failure to demonstrate progress on a permanent housing plan or to meet eligibility requirements may result in termination of direct temporary housing assistance.

13. FEMA TERMINATION OF MLRP ASSISTANCE.

a. Eligibility. During the term of this agreement FEMA will periodically determine the Applicant's continued eligibility for temporary housing. FEMA may terminate an applicant's assistance when:

i. The applicant violates any of the terms of this Temporary Housing Agreement, the lease terms and conditions between the Landlord and Applicant or other rules, regulations or laws of the jurisdiction or site where the THU is located;

ii. The Applicant's occupancy is terminated by the Owner for violation of the lease terms and conditions between the Landlord and Applicant.

iii. FEMA has determined that adequate alternative housing is available to the household outside of direct temporary housing assistance;

or

iv. The Applicant has not provided verifiable information demonstrating that the household is working towards a permanent housing plan; or

v. The household obtained housing assistance through either misrepresentation or fraud.

vi. The household has engaged in criminal activity, activities that create serious health and safety risks, or any other unlawful or otherwise illegal activities.

b. End of the Period of Assistance. At the end of the term of this agreement, FEMA may terminate assistance. In accordance with the Stafford Act, temporary housing assistance shall be provided for a period of up to18 months from the date of the Presidential declaration. Stafford Act Section 408(c)(1)(B)(ii), 42 U.S.C §5174(c)(1)(B)(ii). If necessary, because of extraordinary circumstances, FEMA may extend the 18 month period of assistance for temporary housing assistance. The terms of this agreement will remain under any extension of MLRP assistance.

14. APPLICANT RESPONSIBILITY TO COMPLY WITH REMOVAL ACTION. The Applicant and the household members will comply with any written Notice of Revocation requiring the Applicant's household to vacate the THU by moving out of the THU, removing all personal property, and returning the THU keys to the Landlord no later than the date set forth in the Notice of Revocation. The Applicant is responsible for the household's personal property, which is placed in the THU at the sole risk of the Applicant and for removing it from the THU upon receiving a written Notice of Revocation.

15. FEMA NOTICE TO APPLICANT REGARDING TERMINATION OF MLRP ASSISTANCE.

a. Termination notice based on Applicant ineligibility: FEMA will provide the Applicant with a Notice of Revocation for a major violation with 3 days to vacate the THU or a general violation with 15 days to vacate the THU.

FEMA will issue a Notice to Surrender Possession to Applicants who remain in the THU beyond the date specified in the Notice of Revocation.

b. Termination notice based on End of the Period of Assistance:

i. FEMA will provide an End of Period of Assistance - 60-Day Reminder Notice to the Applicant 60 days prior to the end of the period of assistance.

ii. FEMA will provide a 30-Day End of Period of Assistance and Penalty Fee Notice of Revocation to the Applicant of the End of the Period of Assistance 30 days prior to the end of the period of assistance.

16. APPLICANT APPEAL RIGHTS TO TERMINATION OF MLRP ASSISTANCE.

a. In accordance with Section 423 of the Stafford Act and 44 C.F.R. Section 206.115, Applicants may appeal the FEMA determination to terminate MLRP assistance within 60 days after the date that FEMA notifies the Applicant.

b. Appeals must be in writing and explain the reason for the appeal to FEMA.

c. The Applicant or Applicant's designee must sign the appeal. If the Applicant's designee files the appeal, then the Applicant must also submit a signed statement giving the Applicant's designee the authority to represent the Applicant.

d. The Applicant must vacate the THU until an appeal decision is provided by FEMA.

e. Applicants may not appeal termination based on the end of the period of assistance.

Initials of Applicant household do not vacate or establish a new lease with the Landlord the rental unit when directed to do so by FEMA. FEMA may also charge the occupant this penalty fee if all members of the applicant's household fail to vacate the rental unit when directed to do so by the Landlord. Payment of the penalty fee does not entitle the applicant or their household to remain within the rental unit. The applicant and their households will remain subject to eviction proceedings and any associated costs and legal fees.

c. The applicant's failure to pay FEMA rent or penalty fee may result in a debt to the Federal Government for which FEMA will be required to pursue through debt collection proceedings.

18. NONDISCRIMINATION. FEMA shall not discriminate against the Applicant or eligible household members in the provision of services, or in any other manner, on the grounds of age, race, color, religion, sex, nationality, age, familial status or disability.

19. THIRD PARTY RIGHTS. The Landlord is not the agent of FEMA.

20. ASSIGNMENT. The Applicant may not assign this agreement to a third party.

21. HOLD HARMLESS AGREEMENT. The Applicant agrees to hold harmless the U.S. Government and any of its agencies, agents, contractors, and subcontractors, for damage of any type whatsoever either to property or persons resulting from such enforcement actions. The Applicant hereby agrees to release, discharge, and waive any action, either legal or equitable, that might arise out of any activities on the premises of the unit or the surrounding area. The Applicant hereby agrees to hold harmless the U.S. Government and any of its agencies, agents, contractors, and subcontractors, for damages of any type whatsoever either to property or persons resulting from its furnishing of housing assistance to the Applicant his or her household members.

22. DUTY OF INSURED APPLICANTS TO REIMBURSE FEMA. FEMA requires all recipients of direct temporary housing assistance to offset the value of the direct assistance provided by FEMA against any insurance proceeds or recoveries they receive. If the Applicant's household is eligible for any payments or allowances from private insurance that can be used for temporary housing needs, such as Additional Living Expenses, the Applicant or other Authorized User will file a claim for such insurance benefits and pay FEMA for the cost (up to Fair Market Rent) of using the THU.

PRINCIPAL PURPOSE(S): This information is being collected for the primary purpose of determining eligibility and administrating financial assistance under a Presidentially-declared disaster. Additionally, information may be reviewed internally within FEMA for quality control purposes.

ROUTINE USE(S): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by routine uses published in DHS/FEMA-008 Disaster Recovery Assistance Files System of Records (September 24, 2009, 74 FR 48763) and upon written request, by agreement, or as required by law.

DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent the individual from receiving disaster assistance.

By signing this agreement, I, the Applicant, have read the terms of this agreement in its entirety, and acknowledge and agree to comply with the requirements stated herein. As the Applicant, I am signing this form on behalf of all members of my household listed above as Authorized Users. All Authorized Users are responsible for complying with the attached Conditions for Use and any other rules incorporated in this Temporary Housing Agreement.

Signature of Applicant or Co-Applicant

Witness

Date

b. FEMA will charge the applicant a monthly penalty fee in the amount of if all members of the applicant's

Title

17. FEMA RENT AND PENALTY FEE.

a. FEMA will charge the applicant monthly rent, up to the Fair Market Rent (FMR) established by HUD when the period of assistance has been extended beyond 18 months. Applicants who cannot afford to pay the full FMR, may appeal the amount of rent based upon their financial ability. Applicants who wish to have their rent reduced must provide documentation verifying the amounts of their income and monthly housing expenses. FEMA will not reduce the amount of rent to below $50.