Downloadable Forms

All applications require the following forms completed by the respective person(s). Applicants, ensure you give your landlord time to complete the forms and turn them in as soon as possible.  Landlords may submit the forms directly to Please reference name of Applicant in the subject line.



**Please Note: Rental payment history between Applicant and Landlord/Property Manager may be requested

** Recertification for additional assistance (required if previously funded):

Documentation Requirements

Documentation requirements, include but are not limited to, the following:

  1. Proof of applicant identity:
    1. Hawaii Driver’s License or State ID, or valid government issued ID
  2. Proof of Kauai County Residency:
    1. Valid and current tenancy at primary residence in the County of Kauai; or
    2. Copy of current and valid lease/rental agreement; or
    3. Copy of recently expired lease/rental agreement if landlord approved month-to-month tenancy; or
    4. Proof of expenses requested, which can include but is not limited to an invoice,
    5. Notice of Rent Change
  3. Proof of applicant and household income, which can include but is not limited to:
    1. 2020 Income Tax Return; or
    2. Other evidence of income at the time of application, including but not limited to:
      1. Unemployment with weekly benefit amount (if unemployed), or PUA benefit letter
      2. Other documents such as most recent tax return, social security benefit letter, public benefit statement, retirement statement, disability statement,etc.
      3. Two most current pay stubs if employed.
      4. Self-Certification of Income ONLY if no other documentation can be provided.
  4. Proof of applicant income loss or increased expenses related to COVID-19 pandemic, which can include but is not limited to:
    1. Layoff, furlough, close of business or hours reduced letter from employer prior to first month of requested assistance, or
    2. Schedule(s) showing reduction in hours for each month requesting assistance, or
    3. Unemployment certification / determination letter
    4. Pay stubs or bank statements demonstrating loss of income, or significant increase of costs
    5. Self-Certification of COVID-19 situation ONLY if no other documentation can be provided
  5. For Rental Assistance requested (Note landlords and property managers may work directly with Kaua‘i Federal Credit Union. You may email the below documents at, with the tenant name in the subject line).
    1. A W-9 tax form from any landlord/property owner. Please note payment will be made directly to the landlord, with the address listed on the W-9, unless otherwise requested by the applicant/landlord.
    2. Vendor Verification Form completed and signed by the landlord/property owner and or Property Manager. Please refer below for a downloadable copy of the form.
    3. Evidence of any rental arrears requested (past due) If you are unable to secure the vendor verification form or W9 documentation from your landlord or property manager, we will assist you in securing these documents. You will not be denied assistance solely because you cannot get your landlord/property manager to submit vendor verification or W9 documentation.
    4. Please note: rental payment history between landlord/Property Manager may be requested. Below are acceptable forms of documentation to validate payment pattern.
      • For applicants, bank statements showing the withdrawals of monthly rent amount to show a pattern of payments.
      • For landlords, bank statements showing deposits of monthly rent amounts into their accounts, to show pattern.
      • Venmo/PayPal payments to landlord, bank transfers etc. Any electronic payment method.
      • Money order receipts, Western Union and Money Gram receipts are accepted
      • Check deposits with landlord name in pay to order of
      • Deposit slips from a financial institution showing rent amount being deposited
      • Handwritten documents/receipts will not be accepted as a form of payment history verification
  6. For Utility Assistance requested:
    1. Past due utility notice

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