Landlord Emergency Rental Assistance Referral Form

As a housing provider, you play an important role in helping administrators of the City of Kansas City's and Clay County's Emergency Rental Assistance Program (ERAP) reach tenants in need of assistance. By completing this referral form, you can identify tenants in your rental property who need assistance and connect United Way to those tenants so that they may complete an ERAP Referral Form. Please note that completing the referral form alone is not sufficient. You must contact your tenant(s) to provide them the tenant application link. In addition, you must provide supporting documents (listed below) and complete a landlord agreement.

*** Please note that only rental properties in Clay County or Kansas City Missouri may apply. ***


Once you have begun a referral form, you must continue to the end. Prior to filling out the referral form you will need to have the correct documentation ready to upload. You will not be able to resume the referral form if the browser is closed while filling out the referral form.

*** Do not refresh the browser or use the browsers "Back" button while filling out the referral form. ***

Below are the documents and information you will need to submit with the ERAP Referral Form:

  • A W-9 form for the landlord's entity. You can download the blank W-9 form here. If you are a individual who owns rental property, you should use the W-9 to provide your social security number. This is a federal requirement, as United Way and its partners must report payments under the ERA Program to the IRS.
  • You will need The following information for EACH property/unit:
    • Consent from each tenant PRIOR to submitting this form. This means you must request your tenant’s permission to include them on this referral form, BEFORE submitting their information.
    • Each tenant's email. If tenant's do not have an email, or did not obtain permission to provide it, you may provide your own email and assist the tenant with completing the referral form process.
    • Each tenant's date of birth.
    • Each tenant's last 4 digits of SSN, ITIN or other ID.
    • A signed landlord agreement.
    • The Lease agreement for each tenant you are referring for assistance.
    • Documentation providing evidence for the need of assistance, such as an eviction notice or past due rent letter that you have previously given your tenant.

Additional Information:

Upon completion of the tenant application form, the data will be sent to the provided email address of the representative. In addition your tenant(s) will receive an email with a link to the tenant application.

*** Payment will not occur until each tenant completes their own application form! ***

After submission of your referral form and supporting documents, you will be contacted by a United Way caseworker. This could take up to six weeks due to the volume of requests. We ask for your patience as we work through the many requests for rental assistance.