R.C.S.A. § 17b-802-4
Elements of Application
Cite as Conn. Agencies Regs. § 17b-802-4
A completed application requesting the equivalent of up to two (2) month's rent as
a security deposit guarantee, or the equivalent of up to one (1) month's rent as a
security deposit and up to one (1) month's rent as a security deposit guarantee, pursuant
to section 17b-802-8 of the Regulations of Connecticut State Agencies, includes:
(1) A completed security deposit guarantee or security deposit application form signed
by the applicant and the department's worker. The application form shall stipulate
that the applicant agrees to notify the department within thirty (30) days of vacating
the dwelling unit for which payment is being requested;
(2) Any documents set forth in section 17b-802-3 of the Regulations of Connecticut
State Agencies, or any other documents that the department determines are necessary
to determine eligibility; and
(3) A written agreement between the department and the prospective landlord which
shall include one or both of the following:
(A) A written security deposit guarantee signed by the prospective landlord and the
department's designee. The written guarantee shall stipulate that the department shall
pay the landlord for any damages suffered by the landlord due to the tenant's failure
to comply with such tenant obligations as defined in section 47a-21 of the Connecticut
General Statutes, provided the amount of any such payment shall not exceed the amount
of the security deposit guarantee; or
(B) A waiver form completed and signed by the prospective landlord. The waiver form
shall stipulate that if the tenant for whom a security deposit payment is made vacates
the dwelling unit, any return of the security deposit or accrued interest to which
the tenant is entitled, shall be paid directly to the department.