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pdfATTACHMENT G: Mobility Services Tracking Tool
Evaluation of the Community Choice Demonstration
The Paperwork Reduction Act Statement: This collection of information is voluntary and will be
used to evaluate the US Department of Housing and Urban Development’s Community Choice
Demonstration. Public reporting burden for this collection of information is estimated to average
12 minutes per response, including the time for reviewing instructions, gathering and
maintaining the data needed, and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless
it displays a currently valid OMB control number. The OMB number and expiration date for this
collection are OMB #: XXX-XXXX, Exp: XX/XX/XXXX. Send comments regarding this
burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden to XX at XXXX@XXX or NNN-NNN-NNNN.
Data fields to be collected on each head of household
Head of Household Name
Head of Household Age
Head of Household Initial Address
Head of Household Current Address
Number of Children
Age of Children
Gender of Children
PHA Name
Voucher size
Estimated voucher issuance date
Actual voucher issuance date
Date of pre-move appointment
(Data from pre-move appointment)
o Barriers to housing search
 Credit report
 Previous rental history
 Previous criminal history
 Issue with a current property manager
 Other [open data entry field]
o Referrals provided
 Housing search workshop
 Renter’s workshop
 Banking and budgeting workshop
 Credit coaching
 Legal services
 Other [open data entry field]
o Initial neighborhoods of interest
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 [Open data entry fields]
o Initial goal move date
o Initial date estimated to begin receiving unit referrals
Has driver’s license [y/n]?
Someone in household has driver’s license [y/n]?
Has access to car that runs [y/n]?
Date of attendance at housing search workshop
Date of attendance at renter’s workshop
Date of attendance at banking and budgeting workshop
Followed up on credit coaching referral [y/n]?
Followed up on legal services referral [y/n]?
Followed up on other referrals [y/n]?
(For each proactive pre-move check-in from the program or contact from the client)
o Date of check-in
o Check-in format
 In-person
 Phone
 Text
 Video call
o Topic discussed
 Barriers to Housing Search
 Credit report
 Previous rental history
 Previous criminal history
 Issue with a current property manager
 Other [open data entry field]
 Referrals provided
 Housing search workshop
 Renter’s workshop
 Banking and budgeting workshop
 Credit coaching
 Legal services
 Other [open data entry field]
 Opportunity neighborhoods
 Neighborhoods of interest
 Questions about neighborhood amenities and features
 Questions about schools
 Other [open data entry field]
 Applications submitted
 Address Address
 Neighborhood
 Contract rent
 Payment standard
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Security deposit
Property owner name
Accepted or denied?
Reason for denial
o Credit report
o Previous rental history
o Previous criminal history
o Other [open data entry field]
 Family financial assistance [open data entry field]
 Owner incentives [open data entry field]
 HCV Issues
 Recertifications
 Inspections
 Other [open data entry field]
 Other topics [open data entry field]
(For each unit referred to the client)
o Address
o Neighborhood
o Bedroom size
o Contract rent
o Payment standard
o Security deposit
o Property owner name
o Property owner previously rented to PHA?
o Property owner previously rented as part of mobility program?
o Date referral provided to client
(For family financial assistance provided on behalf of the client)
o Application fee
 Amount
 Paid date
 Paid to
 Paid for address
o Transportation stipends
 Amount
 Paid date
 Bus or train
o Holding Fee
 Amount
 Paid date
 Paid to
 Paid for address
 Kept by owner due to family backing out [y/n]?
o Security Deposit
 Amount
3
 Paid date
 Paid to
 Paid for address
o Utility Arrears
 Amount
 Paid date
 Paid to
o Administrative or Processing Fees
 Amount
 Paid date
 Paid to
 Paid for address
o Move-in Fees
 Amount
 Paid date
 Paid to
 Paid for address
o Coach’s Discretionary Fund
 Amount
 Paid date
 Paid to
 Purpose [open data entry field]
(For owner incentives paid to a property owner associated with the client)
o Signing Bonus
 Property owner name
 Property owner address
 TIN
 Amount
 Paid date
 Paid to
 Paid for address
o Damage Mitigation Fund
 Property owner name
 Property owner address
 TIN
 Amount
 Paid date
 Paid to
 Paid for address
(Unit Approval Process)
o Date request for tenancy approval (RFTA) received
o Property owner
o Address
o Contract rent
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o Bedroom size
o Payment standard
o Neighborhood
o Date RFTA approved
o Date inspection scheduled for
o Date second inspection scheduled for
o Unit pass/fail
o Lease start date
o Move-in date
o Date welcome packet mailed
o Scheduled date for initial post-move check-in with client
o Scheduled date for initial post-move check-in with owner
(For each proactive post-move check-in from the program or contact from the client)
o Date of check-in
o Check-in format
 In-person
 Phone
 Text
 Video call
o Topics discussed
 Accessing neighborhood features and amenities
 School and/or day care enrollment
 Property owner interactions
 Upkeep of the home
 Utility transfers
 Meeting neighbors
 Transportation
 Retention in neighborhood/opportunity area
 Other topics [open data entry field]
o Referrals provided
 Credit coaching
 Legal services
 HCV case manager
 Second move services
 Other [open data entry field]
o Scheduled date for follow-up check-in
(For post-move one month check-in with owner)
o Date of check-in
o Check-in format
 In-person
 Phone
 Text
 Video call
o Topics discussed
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 HAP payments
 Incentive payments
 Client interactions
 Upkeep of home
 HCV questions
 Other [open data entry field]
Date moved to phase 3: family preparation
Date moved to phase 4: searching and applications
Date moved to phase 5: leasing-up
Date moved to phase 6: post-move
Date moved to phase 7: successful move
Date moved to inactive clients caseload
Date client requested to unenroll in study
Data fields to be collected on property owner recruitment and engagement
Property Owner Events
o Property owner advisory group meeting
 Date of advisory group meeting
 Time length of advisory group meeting
 Time spent preparing for advisory group meeting
o Property owner outreach event
 Date of outreach event
 Time length of outreach meeting
 Time spent preparing for outreach event
Property Owner Engagement
o Number of property owners contacted, daily
o Number of new units listed, daily
o Time spend engaging with property owners
For each unit listed by the program
o Address
o Neighborhood
o Contract rent
o Bedroom size
o Payment standard
o Security deposit
o Property owner name
o Property owner previously rented to PHA?
o Property owner previously rented as part of mobility program?
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| File Type | application/pdf | 
| File Title | Microsoft Word - Redline.Attachment G Mobility Services Tracking Tool.docx | 
| Author | H03483 | 
| File Modified | 2025-05-19 | 
| File Created | 2025-05-19 |