Participant agrees to abide by the Program Rules and receipt of the rules is acknowledged by your signature below.1 These standards will be applied fairly and uniformly to all Participants. Failure to abide by the Program Rules can result in eviction and/or termination of the program subsidy.

The program prohibits all of the below activities and involvement in any of the following activities may lead to termination of the program rent subsidy and/or eviction:

1. Tenants must pay rent on time, according to the lease provisions.

2. Tenants must notify Brilliant Corners (BC) of any household income changes within 10 business days of

   whichever comes first: a) the date on which the tenant received notice of the income change or b) the date on

   which the tenant experiences an actual change in income.

3. Tenants must comply with interim and/or annual income re-certifications.

4. Tenants must work towards maximizing their income by securing all benefits for which they qualify.

5. Tenants must submit a vacancy request for planned vacancies of more than 30 days.

   Support services staff will submit an emergency vacancy form for unexpected vacancies for medical reasons. (Not Application to ERC)

6. The assigned HFH housing site must be the tenant’s sole residence and the tenant must reside in their unit.

7. Tenants who are late with rent by 45 days or who have made 3 late payments in a 12

   month period will be required to enroll in a third party rent payment program (fees associated with third party rent payment/representative payee will be the responsibility of the tenant).

I agree to allow Brilliant Corners (BC) and/or BC Service Partners, (see box below), to share my information with each other and/or 3rd party housing agents for the following purposes:

1. BC and/or BC Service Partners may use my information to provide me with housing, case management, integrated and/or coordinated services, and to assist in providing alternative temporary and/or permanent housing opportunities.

2. BC and/or BC Service Partners may use or disclose my information for research purposes, subject to the requirements of applicable law, and to make recommendations on policies to improve services for people experiencing homelessness.

3. I understand that if I sign this agreement, I voluntarily consent and hereby authorize BC to release and disclose information about me to BC Service Partners and/or 3rd party housing agents.

4. I understand that if I sign this agreement, I voluntarily consent and hereby authorize BC Service Partners and/or 3rd party housing agents to release and disclose information about me to BC.

5. I understand and agree that I will receive no money or other benefits from the BC, BC Service Partners or any other party as a result of consenting to the release of such information.

6. I agree to release BC, BC Service Partners, its agents and employees from any liability whatsoever, including for injuries, damages and losses, known or unknown, resulting from sharing the information with other City or County departments, homeless service providers and housing locators, with whom the BC has relationships.

7. I acknowledge that before signing this consent for release agreement, I have carefully read and fully understand its terms. If I am unable to read, the person asking me to sign this form has read and explained all of the items/terms listed in this agreement.

8. This agreement shall become effective on the date provided below and will expire five years from the date below, unless revoked in writing at an earlier date. 

As a condition of my application as a program participant, adult occupant, who is an eligible participant for the Flexible Housing Subsidy Pool Program (FHSP), I understand that Brilliant Corners will request consumer reports on me from a consumer reporting agency for program purposes. The types of information that may be obtained include but are not limited to: credit reports, Social Security Number verification, criminal records checks, sex offender records checks, public court records checks, driving records checks, verification of employment positions held, workers’ compensation records, personal and professional references checks, licensing and certification checks, etc.

By agreeing to this Acknowledgement and Authorization, I authorize Brilliant Corners and /or any other company authorized by Brilliant Corners, to access such information as may be necessary to complete a criminal background check.

I release from liability all persons and entities supplying such information. I indemnify Brilliant Corners and/or other company authorized by Brilliant Corners, against any liability which may result from making such requests. I agree that a fax or copy of the Acknowledgment and Authorization with my signature will be accepted with the same authority as the original. I understand that upon my request, I will be given a copy of the background report and, when applicable, a written description of my rights under the Fair Credit Report Act.