MVUTS.org — nonprofit tenant support and advocacy

914-699-1114
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Westchester County Inter-Agency Intake Form for Eviction Prevention

This is the county intake form for tenants who are behind on rent or facing eviction. It has 13 short sections. You can save your place and come back later, and you can speak your answers instead of typing them.

Your information is private

Everything you enter, including your documents, is stored privately and is visible only to authorized MVUTS staff. Nothing on this form is ever shown publicly. If you would rather complete this form with a staff member, call 914-699-1114.
Already started? Continue where you left off

Step 1 of 13: Head of Household

Head of Household

Tell us about the person applying for help. This should be the adult whose name is on the lease or the court papers.

Required by the county for benefit matching. Stored privately and shown to staff only as the last four digits.

If you have an email address, please provide it so we can contact you about your application. If you don’t, you can still apply.