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HousingOfficial formconditional

HUD-5383 Emergency Transfer Request

Official owner U.S. Department of Housing and Urban Development

Official document

Open the official form

Issued by
U.S. Department of Housing and Urban Development
Form number
HUD-5383
Last checked
Sep 30, 2026
Download / open official form

Opens the copy posted by U.S. Department of Housing and Urban Development. Revision shown on our record: Unknown. Before using it, confirm the form number and revision match.

HUD’s emergency-transfer request form for qualifying violence or abuse in covered housing programs.

What problem this helps solve

HUD’s emergency-transfer request form for qualifying violence or abuse in covered housing programs.

Who completes it: A tenant or household member in a covered housing program requesting an emergency transfer under the form’s stated conditions.

What this does not prove

Use a safe contact method and the covered provider's VAWA Emergency Transfer Plan. A request does not promise an available unit.

Dated source check

Official destination checked

The official three-page PDF was retrieved September 30, 2026. January 31, 2028 is the displayed OMB expiration, not a revision date; no revision date is asserted.

Last checked Sep 30, 2026. A working link does not establish the current edition, suitability, agency acceptance, or service availability.

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Steps for using this form

Use the official pathway

No One Left Outside's preparation notes summarize the dated sources in this record. Follow the agency's official instructions and current edition when they differ.

1. Check that this route fits

Stage and purpose
Request an emergency transfer under the provider's VAWA Emergency Transfer Plan.
Who completes it
A tenant or household member in a covered housing program requesting an emergency transfer under the form’s stated conditions.
Jurisdiction
United States; covered housing programs
Application mode
Obtain and complete the provider's emergency-transfer request process; Submit the HUD form to the covered housing provider using a safe communication route

2. Prepare before starting

  • Confirm the housing program is covered and obtain the provider's transfer plan.
  • Use safe contact information and ask about confidential handling.
  • If the provider requests victim documentation in writing, ask which permitted documentation options apply.

Documents named by the source

  • The form contains its own certification language; ask the covered housing provider what its current process requires.
Fees and fee waivers
UNKNOWN; the form does not establish a universal transfer charge.
Account
No universal online-account requirement is stated on this paper form.
Appointment
UNKNOWN; ask the covered provider for a safe submission route.
Signature
The tenant signs and dates the certification on the official HUD form.
Third-party certification or assessment
The tenant certifies the statements and signs and dates the official form.

3. Follow official submission instructions

Read official instructions
  • Submit through the covered housing provider’s current emergency-transfer process.

4. Get help or an accommodation

Languages: Language versions were not verified for this direct PDF.

Accessibility: The official form explains language assistance and reasonable accommodations, including help completing the form; contact the covered provider. PDF conformance was not evaluated by No One Left Outside.

5. Know the supported next step

  • Keep a safe copy and ask the provider for acknowledgement and the next transfer step.

Restrictions and unresolved details

  • Applies to covered housing programs and does not promise an available transfer unit.
  • Documentation and timing depend on the written request and provider transfer plan.

Use a safe contact method and the covered provider's VAWA Emergency Transfer Plan. A request does not promise an available unit.

PDF filling support

PDF with fillable fields. Checked 2026-10-05. Signature support and agency acceptance still need confirmation.

Continue with your journey

Return to the connected step to decide what to do next. Opening this record does not complete that step or submit an application. If the official route is unavailable, use the assistance options above or browse help in the journey.

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Form record

Adds to a private plan in this browser tab. Nothing is sent to the provider, and nothing is applied for.

Official title
HUD-5383 Emergency Transfer Request
Form number
HUD-5383
Program
VAWA covered-housing protections
Jurisdiction
United States; covered housing programs
Revision / edition
Unknown
Who completes it
A tenant or household member in a covered housing program requesting an emergency transfer under the form’s stated conditions.
Signature
The tenant signs and dates the certification on the official HUD form.
Submission methods
Submit through the covered housing provider’s current emergency-transfer process.
Supporting documents
  • • The form contains its own certification language; ask the covered housing provider what its current process requires.
Languages
Language versions were not verified for this direct PDF.
Accessibility
The official form explains language assistance and reasonable accommodations, including help completing the form; contact the covered provider. PDF conformance was not evaluated by No One Left Outside.

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Source note: Use a safe contact method and the covered provider's VAWA Emergency Transfer Plan. A request does not promise an available unit.

No One Left Outside does not process this form, receive your answers, decide eligibility, or represent the agency. A destination check does not confirm current funding, acceptance, or an outcome.

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