Forms for Victims of Domestic Violence

The Violence against Women Act of 2013 (VAWA) provides special protections for victims of domestic violence, dating violence, sexual and stalking who are applying for or receiving assistance under the Housing Choice Voucher (HCV) program. Below is a list of helpful forms related to protection under VAWA.

HUD-5380 Occupancy Rights under VAWA

HUD-5382 Certification of Domestic Violence

Housing Works Emergency Transfer Plan

HUD-5383 HUD Emergency Transfer Request

Tenants who are or have been victims of domestic violence are encouraged to contact the National Domestic Violence Hotline at 1-800-799-7233, or a local domestic violence shelter, for assistance in creating a safety plan.  For persons with hearing impairments, that hotline can be accessed by calling 1-800-787-3224 (TTY).

Tenants who have been victims of sexual assault may call the Rape, Abuse & Incest National Network’s National Sexual Assault Hotline at 800-656-HOPE, or visit the online hotline at

Tenants who are or have been victims of stalking seeking help may visit the National Center for Victims of Crime’s Stalking Resource Center at