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VAWA Certification of Domestic Violence, Dating Violence or Stalking

As part of the Violence Against Women Act (VAWA) Reauthorization of 2013, HUD recently issued the following form to assist PHAs, owners or managers in obtaining written evidence from an applicant/tenant seeking protection under VAWA to demonstrate that domestic violence, dating violence or stalking occurred.

This is an optional form. The victim has the option of either submitting this form or submitting third-party documentation. If this form is used by the victim, the victim must complete and submit it within 14 business days of receiving it from the PHA, owner or manager.

To review this form, please click here (Word document format).

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