Organization and Project Identifiers Organization Name Operating Date Operating End Date Notes about any changes to Organization Name, Project Name or Project Type Organization Address Project Name Project Type ONE Coordinated Assessment Day Shelter Emergency Shelter Homelessness Prevention Other PH - Permanent Supportive Housing (disability required for entry) PH - Rapid Rehousing 1. only one Project Type. PH - Housing with Services (no disability required for entry) PH - Housing Only Retired (no longer entering data) Safe Haven Services Only Street Outreach Transitional Housing Affiliated with a Residential Project: Yes No If yes, list project □ □ Housing Type Site-Based-Single Site Site-Based-clustered/multiple sites Tenant-based-scattered site □ □ □ Principal Site Yes No Target Population DV: Domestic Violence victims HIV: Persons with HIV/AIDS NA: Not Applicable □ □ □ □ □ Victim Services Provider Yes No □ □ Method for Tracking Emergency Shelter Utilization Entry/Exit Night by Night □ □ Continuum Project Yes No □ □ Provider Type RHY PATH SSVF □ □ □ □ Service Transaction Workflow Yes No □ □ CoC Code NE-500 Balance of State NE-502 Lincoln CoC Code Start Date CoC Code End Date □ □ Geocode ZipCode Geography Type Suburban Rural □ □ □
Organization and Project Identifiers Organization Name Operating Date Operating End Date Organization Address Notes about any changes to Organization Name, Project Name or Project Type Project Name Project Type ONE 1. only one Project Type. Coordinated Assessment Day Shelter Emergency Shelter Homelessness Prevention Other PH - Permanent Supportive Housing (disability required for entry) PH - Rapid Rehousing PH - Housing with Services (no disability required for entry) PH - Housing Only Retired (no longer entering data) Safe Haven Services Only Street Outreach Transitional Housing Affiliated with a Residential Project: □ Yes □ No If yes, list project Housing Type □ Site-Based-Single Site □ Site-Based-clustered/multiple sites □ Tenant-based-scattered site Principal Site □ Yes □ No Target Population □ DV: Domestic Violence victims □ HIV: Persons with HIV/AIDS □ NA: Not Applicable Victim Services Provider □ Yes □ No Method for Tracking Emergency Shelter Utilization □ Entry/Exit □ Night by Night Continuum Project □ Yes □ No Provider Type □ □ RHY □ PATH □ SSVF Service Transaction Workflow □ Yes □ No CoC Code □ NE-500 Balance of State □ NE-502 Lincoln CoC Code Start Date CoC Code End Date Geocode ZipCode Geography Type □ □ Suburban □ Rural