Recovery Housing Compliance Attestation

Recovery Housing Compliance Attestation
Attestation by recovery housing operators confirming compliance with program requirements.
Residence Name
Program/Operator Name
Property Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Person Full Name
First NameLast Name
Contact Person Role/Title
All staff have completed required training.
The residence meets all safety and occupancy standards.
Resident rights and grievance procedures are posted and accessible.
Date of Attestation
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I attest that the information provided is accurate and the residence complies with all applicable program requirements.
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