State of Indiana
Lieutenant Governor
Suzanne Crouch
ADDRESS 30 South Meridian Street, Suite 900, Indianapolis, IN 46204
PHONE 317 232 7777 TOLL FREE 800 872 0371 WEB www.ihcda.IN.gov
EQUAL OPPORTUNITY EMPLOYER AND HOUSING AGENCY
Indiana COVID-19 Rental Assistance Program
Checklist for Landlord Documentation Submission
This checklist has been provided as a tool to assist landlords in submitting correct and complete
documentation containing all elements necessary for the application review. This document does
not need to be returned to IHCDA.
Lease/Rental Contract
Lease is currently active OR contains automatic renewal or month-to-month language.
Document includes landlord and tenant signatures.
Lease Addendum
Tenant” field includes the names of all leaseholders.
Table A has been completed, with the following considerations:
Arrears do not date prior to April 1, 2020.
The amount requested from IHCDA does not exceed the monthly cost of rent.
The amount requested from IHCDA does not include any costs other than rent or late
fees for unpaid rent.
The amount owed to the landlord matches the rental rate described in the lease. If there
is a discrepancy, documentation (e.g., notice of rent raise) is provided.
Document includes landlord and tenant signatures.
Note: All four pages of the Lease Addendum must be returned to IHCDA.
IRS Form W-9
Document is complete with landlord/property management information.
Line 1 is complete with individual or entity name. (Note: Do NOT leave this line blank. Some
entities may complete both lines 1 and 2.)
Document includes signature.
Note: Form instructions (pages 2-6 of the Form W-9) do not need to be returned to IHCDA.
Landlord Payment Information Form
Document is complete with landlord/property management information.
If requesting direct deposit:
Account information is legible and correct.
Signature is included.
If requesting payment via check:
Preference is clearly indicated by marking the checkbox.
Address is clearly written.