Thank you for your interest in the Kansas Eviction Prevention Program!

Program information, flyers, and FAQs are available on our website: https://kshousingcorp.org/eviction-prevention-program/


Kansas Eviction Prevention Program Landlord Certification

Welcome to the Landlord Certification. Please fill everything out in full, and do not start this application until you have your W9 & KHRC Vendor Information form ready to upload.

Incomplete information WILL DELAY application processing.

Please Note

Only one certification is needed per tax-ID number.

Please help us process efficiently by SIGNING and DATING where indicated.

Have these four documents ready to upload prior to starting the form.

  • W-9 (SIGN & DATE)
  • Vendor Form
  • Copy of Voided Check

Complete a W-9 & Vendor Form here

This will open another form for you to fill out your W9 and KHRC Vendor Information. Upon submitting the form, you will receive an email including your combined W9 and KHRC Vendor information. Download this document, SIGN, then upload it as prompted below.

or 

Download our W-9 Form

Download our Vendor Form

These links will take you to a fillable PDF. Download both documents, enter your details, SIGN, then upload each as prompted below.

Property Information

Physical Address of Property*

Landlord / Owner Information

Would you like to add an Authorized Agent?
Landlord / Property / Owner Authorized Agent*
Business Address*
Please ensure this matches what's on your W9

Landlord Uploads

Please Note: Have these documents ready to upload when completing the application.

Complete a W-9 & Vendor Form here

This will open another form for you to fill out your W9 and KHRC Vendor Information. Upon submitting the form, you will receive an emailed including your combined W9 and KHRC Vendor information. Download this document, then upload it as prompted below.

or 

Download our W-9 Form

Download our Vendor Form

These links will take you to a fillable PDF. Download both documents, enter your details, SIGN, then upload each as prompted below.

No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
Did you sign the W-9 form?*

Landlord / Owner Certification

All boxes must be able to be checked to qualify.

I certify that the information presented in this application is true and accurate to the best of my knowledge and belief. I authorize Kansas Housing Resources Corporation (KHRC) and any other Federal or state agency, to verify and investigate such information, and commit my full cooperation at any time. I understand that providing false, misleading or incomplete information may result in the application being declared void and may result in my having to repay any funds I have received on my tenant's behalf. I understand that it is a criminal violation under Kansas law to make a false statement in writing for the purpose of procuring assistance from a state agency. 


I acknowledge and agree to the requirement that I must not evict the renter for non-payment of rent associated with any of the months for which the rent relief payment is made. Furthermore, I understand that KHRC funds cannot be used to pay rent charged prior to April 1, 2020. I understand if the renter owes past due rent charged prior to April 1, 2020, I must work with the tenant to develop an appropriate payment plan. I certify that, as part of the intake and assessment of the household, I have attempted to assist the household with identifying other resources that may be available to them to prevent eviction without using KEPP funding, including savings, linkages to mainstream and natural supports. I will advise Tenant on next steps if Tenant finds they are unable to pay rent in the future. Furthermore, I acknowledge and agree to reimburse KEPP funds to KHRC if it is determined at a later date that I or my Authorized Agent(s) (identified below) recorded inaccurate information contained in the Tenant Application Packet that resulted in determining the Tenant eligible for KHRC financial assistance when Tenant was actually ineligible for said assistance. Furthermore, I release and shall hold harmless the state of Kansas, KHRC, its grantees, agents, and employees from all claims and demands that relate to or arise out of my application to the KEPP and any action or inaction taken by the state of Kansas, KHRC, its grantees, agents and employees in the administration and management of the KEPP. I shall maintain all contractual and household records for at a minimum of five years, and shall provide access to such records by KHRC as may be requested. I confirm that, in processing tenant’s application, I have complied with all applicable fair housing laws, including but not limited to, Fair Housing Law which makes it illegal to discriminate in residential housing on the basis of race, color, religion, national origin, sex, familial status, source of funds, sexual orientation, gender identity, status as a veteran, or disability.


If this Application is completed by an Authorized Agent on behalf of Landlord, Authorized Agent hereby certifies that it is duly authorized to act on behalf of Landlord as its agent with respect to this Application, including, but not limited to, the Landlord Agreement set forth above. The Landlord / Authorized Agent’s agreement with the certifications, terms, and conditions set forth herein is evidenced by the following signature.


I understand that all information submitted to KHRC related to this application may be subject to Kansas' Open Records Law. Furthermore, I am aware that funds will not be disbursed until Tenant has been determined to be eligible and all proper certifications have been submitted.

Date*
Use your mouse or finger to draw your signature above

Processing Lead Assignment

KEPP Processing Team

Google Maps
Go to Google maps and verify the address is valid. https://www.google.com/maps
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

Finance

SAM Verified
W-9 & Vendor Form Verified
This field is used in the GP import. This tells us whether or not to send a 1099.
Voided Check Verified

Upload fields

No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

Deny or Fraud

Click this button to deny this application
Please select below if this certification is being investigated for possible fraud:

KHRC Notes

KEPP Add to GP Step

Place the Vendor ID in this field. This will be sent to the landlord upon approval.

Final Approval

Finance Team Approval*

KHRC Use - After Approval

Select here when the Vendor's banking information has been entered into GP:
Progress