Rental Counseling Application

Dear Consumer,

Thank you for contacting Kingdom Community Development Corporation for assistance with your rental difficulty. We provide comprehensive rental counseling for clients who are delinquent on their rent and/or facing an eviction. Rental counseling is a cooperative process where the counselor acts as a facilitator and educator rather than a lending expert. We are here to help!
Please bring the following with you to your appointment:
  • Lease Agreement
  • Statement or letter from landlord regarding amount owed
  • Proof of income (paystubs, award letter, etc.)
  • Copies of all household expenses
Please be prepared to discuss the hardship which caused you to fall behind, your sources of income, and your household expenses.

If you are going to be late, please call in advance to let us know. If you have any other questions, please call the office during normal business hours. with Our office is open from 9:00 am – 6:00 pm Monday – Thursday 9:00 am to 1:00 pm Friday.

Please note: If you need assistance due to language barriers, mobility impairments, visual or hearing impairments, or any other disabilities, please let us know so that we can provide necessary accommodations.

Kingdom CDC Staff
Present Housing Situation:
Note: If any problem after signing occurs, please click the blue button with red X to clear it and sign again.
Rental Insurance
Medical Expenses
Counseling Services and Disclosure Statement
I/We understand that it is my/our right and responsibility to decide whether to engage in any course of housing counseling with kingdom Community Development Corporation and to determine if counseling is suitable for my housing concerns.

I/We understand that I am not obligated to receive, purchase or utilize any other services offered by Kingdom Community Development Corporation, or its exclusive partners, in order to receive housing counseling.

I/We understand that Kingdom Community Development Corporation has the discretion to charge reasonable fees for counseling services, and that fees will be addressed prior to any counseling appointments. I further understand that no fee will be charged if it creates a financial hardship, nor will I be denied counseling if I cannot pay the fee.

I/We understand that Kingdom Community Development Corporation provides information on a broad range of housing programs and products and that the housing counseling received from Kingdom Community Development Corporation in no way obligates me to choose any particular loan product or housing program discussed in my counseling session.

I/We understand that Kingdom Community Development Corporation does not guarantee that I will receive mortgage financing from any lender and/or other mortgage financing entity. I/We understand that the counselor may answer questions and provide information but must refrain from giving legal advice.

I/We have read and understood the Kingdom Community Development Corporation counseling disclosure statement.
Rental Housing Counseling Services and Partnership Disclosure Form
Counseling agencies are committed to serving clients that are rent burdened or may be facing eviction. Rental Housing Counseling may make you aware of products and/or services that we believe offer value to our clients. These products and/or services might be available directly from Housing Counselors or other agencies with which Counselors has a working relationship. You are under no obligation to us, the products and/or services identified by Housing Counseling, whether by us or from industry partners.

Services provided by Agency:
DPC: Mortgage Delinquency and Default Resolution Counseling
PPF: Pre-Purchase Counseling
RHC: Rental Housing Counseling
FHW: Fair Housing Pre-Purchase Education Workshop
PPW: Pre-Purchase Homebuyer Education Workshops
RHW: Rental Housing Workshops
Privacy Notice
Kingdom Community Development is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We assure you that all information shared, both orally and in writing, will be managed within legal and ethical considerations. Your personal financial information, such as your total debt information, income, living expenses, and personal information concerning your financial circumstances, will be provided to creditors and possibly others with your specific authorization.

We may also use aggregated case file information for the purpose of evaluating services, gathering valuable research information, and designing future programs. Your anonymity will be maintained through the use of your client number or by using aggregated data in all circumstances.

In all other situations, your information may be released to appropriate individuals or agencies ONLY UPON WRITTEN REQUEST or when our staff has been serviced by a valid subpoena.

The following PRIVACY PRACTICES detail the circumstances under which we will release your information to a third party:
  1. We do not disclose any nonpublic personal information about the client or former clients to anyone, except permitted by law.
  2. We may compile data and aggregate information that you give us, but this information may not be disclosed in a manner that would personally identify you in any way.
  3. We may disclose some or all of the information that we collect, as described below, to creditors, or third parties that you have authorized who need this information in order for us to assist you after a counseling session.
  4. We may disclose all of the information thatwecollect as described below creditors and related financial institutions who need this information in order to put you on a debtsolver program (DSP).
  5. We restrict access to nonpublic personal information about you to those employees who need to know that information to provide services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.
  6. We collect nonpublic personal information about you from the following source:
    a. Information we received from you, our application, or other forms that may be provided
    b. information about your transactions with us, your creditors, or others, and
    c. information we receive from a credit reporting agency.
  7. We may disclose the following kinds of nonpublic information about you:
    a. Information we receive from you on applications or other forms, such as your name, address, social security number, assets, and income
    b. information about your transactions with us, your creditors, and others, such as your account balance, payment history, parties to transactions, and credit card usage; and
    c. information we receive from your credit reporting agency, such as your credit history.
RELEASE: I hereby authorize Kingdom Community Development Corporation to release all nonpublic information it obtains about me, to (1) my creditors and (2) any third parties necessary to resolve the matter(s) discussed during my counseling session.

I further RELEASE and authorize all of my creditors to provide nonpublic information about me to this Housing. Counseling Agency
Authorization to Release Information
authorize the release of any personal and financial information requested by Kingdom Community Development Corporation employees Amy Kemp, Tiffany Johnson, Remona Gregory or other delegated staffer including:

  • Employment and Income Records
  • Checking, Savings, and/or Other Deposit Account Records Social Services, VA, and Other Benefit Payment Verifications
  • Courthouse and Other Public Records (titles, liens, taxes, fixed assets verifications, etc.)
  • Creditor and/or Collection Account Information
  • Mortgage Account Information AND/OR documents, Foreclosure Information, and/or Rental history
This authorization should be extended to any employee of Kingdom CDC identifying themselves with the company information listed below AND with the required personal information to identify me.

Upon receipt, you are authorized to speak with KingdomCDC employees by phone and to provide information both verbally and in writing as requested. This authorization should be considered ongoing and enforced indefinitely from the date of signature.
Required Documents Checklist
Upload your most recent month’s paystubs for all borrowers, proof of additional income, your two(2) most recent bank statements and your 2022 tax return including your W-2’s and tax schedule: