1 Prior Rental Evictions No Rental Evictions (0 points) ○ ○ Currently at Risk of Losing Tenant Based Housing Subsidy or Housing Subsidized Building or Unit? Yes ○ ○ History of Literal Homelessness (street/shelter/transitional housing) 4 or More Times or Total of at Least 12 Months in Past ○ ○ 2-3 in the Past Three Years Three Years 1 Time in the Past Three Years None (0 points) ○ ○ Head of Household with Disabling Condition (physical health, mental health, Substance use) that directly affects ability to Secure/Maintain Housing? Yes ○ ○ Criminal Record for arson, drug dealing/manufacture or felony offense against persons or property? Yes ○ ○
○ 1 Prior Rental Evictions ○ No Rental Evictions (0 points) Currently at Risk of Losing Tenant Based Housing Subsidy or Housing Subsidized Building or Unit? ○ Yes ○ History of Literal Homelessness (street/shelter/transitional housing) ○ 4 or More Times or Total of at Least 12 Months in Past Three Years ○ 2-3 in the Past Three Years ○ 1 Time in the Past Three Years ○ None (0 points) Head of Household with Disabling Condition (physical health, mental health, Substance use) that directly affects ability to Secure/Maintain Housing? ○ Yes ○ Criminal Record for arson, drug dealing/manufacture or felony offense against persons or property? ○ Yes ○