NYC HRA Form W-145G is a shelter facility referral form that a Department of Homeless Services worker at your shelter fills out and sends to a designated HRA Job Center so you can apply for Cash Assistance and, through it, a rental assistance program. You do not fill it out yourself. If a shelter worker has mentioned the form to you, it means the shelter is starting the paperwork that connects you to benefits meant to help you move into permanent housing.
Who Fills It Out and Who Gets It
The W-145G is an internal referral between two city agencies. A DHS worker at your shelter completes it and forwards it to a specific HRA Job Center. The form tells that Job Center which rental assistance program you’re being referred for and gives the basic household information the center needs to open a Cash Assistance case for you.
The referral is aimed at working single adults and childless couples living in shelter whose shelter costs are relatively low, though the exact criteria have shifted as rental assistance programs have changed over the years. Nothing on the form is signed by you. The DHS worker’s signature is what makes it valid; without it, the receiving Job Center won’t process the referral.
What the Form Says About You
Even though you don’t complete the W-145G, it’s worth knowing what the shelter is sharing with HRA so you can correct anything wrong before it goes out. The form includes:
- The date of the referral.
- Your full legal name as it appears in shelter records.
- Your shelter entry date.
- The originating shelter facility.
- The receiving Job Center where you’ll apply.
- The rental assistance program you’re being referred for.
- Household composition: names, relationships, income amounts, and income sources for everyone in your household.
- The DHS worker’s signature authorizing the referral.
If any of that looks wrong, ask the DHS worker to fix it before submitting. Errors in names, income figures, or household members can slow down the Cash Assistance decision on the other end.
Your Next Step After the Referral
The referral itself doesn’t grant you anything. It tells HRA you’re coming and why. The actual application happens when you go to the Job Center listed on the form, sit for a Cash Assistance interview, and hand over your documents.
Cash Assistance eligibility comes first. That eligibility is what unlocks the rental assistance program you were referred for. If you qualify, HRA works with you on the rental assistance side, which helps cover housing costs so you can leave the shelter system.
Documents to Bring to the Job Center
HRA requires proof of identity, Social Security number, income, and your shelter status. Plan on bringing:
- A photo ID such as a driver’s license, state ID, or passport.
- Your Social Security card or another document showing your SSN.
- Proof of any income you have: a current pay stub, business records, a tax return, or an Unemployment Insurance benefit statement.1ACCESS NYC. Cash Assistance
- Shelter placement documentation, which your shelter can provide.
If you’re self-employed, bring whatever records you have: receipts, invoices, or a log of payments and business expenses. The Job Center worker will use those to figure your net self-employment income. When accurate tax or business records aren’t available, you may be asked to complete a self-employment income statement listing each payment, who paid it, when, and your work-related expenses.
Gather everything before the appointment. Missing paperwork is the most common reason applications stall, and delays can push back when the rental assistance piece starts.
Sending HRA Additional Documents Later
After the initial appointment, HRA often asks for more verification. You have several ways to get documents in:
- The ACCESS HRA mobile app. Photograph each document and upload it to your case file. This is the fastest option.
- The ACCESS HRA online portal. Log in and upload scanned files from a computer.
- In person at the Job Center or an HRA Benefits Access Center. Ask for a receipt as your proof of submission.
- By mail to the specific Job Center or SNAP center managing your case, using the address on any correspondence HRA has sent you.
Keep copies of everything. If a document gets lost in the system, a backup saves you from starting over.
How Long Processing Takes
Federal law requires eligible households to receive SNAP benefits within 30 days of an initial application, and households eligible for expedited service must receive them within seven days.2Food and Nutrition Service. SNAP Application Processing Timeliness Cash Assistance applications in New York follow a similar 30-day window. The rental assistance layered on top of the W-145G referral can take additional time depending on housing availability and the specific program’s requirements.
After you upload or deliver documents through ACCESS HRA, allow several business days for the agency to scan and attach them to your case. Check the “Documents Sent” section in ACCESS HRA to confirm receipt. If a document shows as received but your case status hasn’t moved after a week, call the Job Center directly.
If You’re Denied or Your Benefits Are Cut
You have the right to request a fair hearing if HRA denies your Cash Assistance application, reduces your benefits, or takes any action you disagree with. Fair hearing requests go through the New York State Office of Temporary and Disability Assistance and can be filed online, by mail, phone, fax, or in person.
The deadlines depend on which benefit is at issue. For SNAP-related actions, you generally have 90 days from the date on the notice. For Cash Assistance, the window is typically 60 days. If you want your benefits to continue unchanged while the hearing is pending, file the request before the effective date on the notice or within 10 days of when the notice was mailed. Miss that window and your benefits may change before the hearing happens, even if you eventually win.
Write down your fair hearing request number and keep copies of everything you file. Bring those copies to the hearing along with any documents that back up your case: pay stubs, letters from employers, shelter records, and anything else that shows your situation.