San Juan Emergency Rental Assistance Program

Landlord Application

Application below – please note this is for San Juan County Landlords only. Please contact your local Community Action Agency for rent assistance in the county in which your tenant resides. There is a separate application for San Juan County Tenants at www.oppco.org/sanjuanrentalassistancetenant

If you are unable to complete the below application and would like to speak with someone about your rental assistance needs, please leave a message at (360) 734-5121 extension 1308. Messages will be responded to in the order in which they are received. Language interpretation services are available.

San Juan Emergency Rental Assistance Program - Landlord Application

  • IMPORTANT: Be sure to click the submit button at the bottom of this page after you complete this form.
    PLEASE NOTE: Allow 2-3 weeks for processing your request. Your request will be processed in the order received.
  • Landlord Information

  • By providing this number you are giving permission to leave a detailed message about your request. If no phone number, please use (000) 000-0000.
  • Secondary phone number (optional)
  • By providing an email address you are giving permission to receive a detailed email response about your request. Please note that phone number will attempted first.
  • Rental Information

    Please complete all rental information requested. Payments to landlords or person authorized to accept payment can only be made up to 150% of the Fair Market Rent rate. Rental assistance is not guaranteed as requested.
  • Monthly RentBedroom Size (ex: studio, 1 bedroom, 2 bedroom, 3 bedroom, etc.) 
    Please list the amount of rent your Tenant is responsible for and the bedroom size of the unit. If you share a residence with your Tenant, please list the number of bedrooms in the house in one line and number of "sleeping spaces" your Tenant is responsible for in the next.
  • Month (ex: June, July, August, etc.)Year (ex: 2020, 2021)Amount Owed 
    Please list the months of rent you are requesting assistance for and the amount past due - must include one month of arrears and can include current and/or future rent due. Rental assistance is not guaranteed as requested.
  • Household Eligibility and Tenant Information

    Your Tenant's household must be eligible based on pre-determined criteria and Opportunity Council must work with them directly for eligibility. By providing your Tenant's information below, Opportunity Council will contact them directly for this information. If your Tenant is unresponsive, ineligible, or eligibility cannot be determined, assistance will be denied
  • Tenant name(s)Tenant phone number(s) 
    Please list the names of adult Tenants and provide phone numbers for them for the household for which you are applying. By providing your Tenants' phone number and/or email you are giving permission to contact them about your request.
  • By providing your Tenant's number and/or email you are giving permission to contact them about your request. Please note that phone number will attempted first.