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12 <br /> 13 <br /> 1 <br /> 2 Victim of Domestic Violence The Local Rent Supplement Program applicants, who <br /> 3 qualify under the definition of Victim of Domestic Violence, <br /> 4 must provide the following documentation at the time of <br /> 5 application to establish that they meet the required criteria: <br /> 6 1. The individual may satisfy the PHA's request by <br /> 7 providing any one of the following three forms of <br /> 8 documentation [24 CFR 5.2007(b)]: <br /> 9 a. A completed and signed HUD-approved <br /> 10 certification form (HUD-50066, <br /> 11 Certification of Domestic Violence, Dating <br /> 12 Violence, Sexual Assault, or Stalking), <br /> 13 which must include the name of the <br /> 14 perpetrator only if the name of the <br /> 15 perpetrator is safe to provide and is known <br /> 16 to the victim; <br /> 17 b. A federal, state, tribal, territorial, or local <br /> 18 police report, or court record, or an <br /> 19 administrative record; or <br /> 20 c. Documentation signed by a person who <br /> 21 has assisted the victim in addressing <br /> 22 domestic violence, dating violence, sexual <br /> 23 assault, or stalking, or the effects of <br /> 24 such abuse. This person may be an <br /> 25 employee, agent, or volunteer of a victim <br /> 26 service provider; an attorney; a mental <br /> 27 health professional; or a medical <br /> 28 professional. The person signing the <br /> 29 documentation must attest under penalty of <br /> 30 perjury to the person's belief that the <br /> 31 incidents in question are bona fide <br /> 32 incidents of abuse. The victim must also <br /> 33 sign the documentation. <br /> 34 <br /> 35 TENANT SELECTION Selection Criteria <br /> 36 Families will be selected based on the following targeted <br /> 37 population selection criteria and selection preference <br /> 38 method. Within the preference category, families and <br /> 39 individuals will be selected based on severity of needs. <br /> 40 <br /> 41 The OCHA system of preferences may select families <br /> 42 either according to the date and time of application, or by a <br /> 43 random selection process. When selecting families from <br /> 44 the Waiting List OCHA is required to use targeted funding <br /> 45 to assist only those families who meet the specified <br /> 46 criteria, and OCHA is not permitted to skip down the <br /> 47 waiting list to a family that it can afford to subsidize when <br /> 48 there are not sufficient funds to subsidize the family at the <br /> 49 top of the waiting list. <br /> 50 <br /> 51 Targeted Population: <br />