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    • Careers
    • Contact Us
  • What We Do
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      • Disaster Recovery
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Mississippi Center for Justice, Inc.
The Fair Housing Project
Tester Application

NOTE TO APPLICANT: The purpose of this form is to determine if you meet criteria necessary for investigation of housing discrimination complaints.

Contact Info

Name(Required)
Address(Required)
MM slash DD slash YYYY

Education

Address
Address

Employment

Are you presently employed?(Required)
Address
Will you be able to conduct a test during your working hours?(Required)
Do you have access to a car?(Required)
Have you ever been convicted of a felony?(Required)
Have you been or are you currently a Real Estate Agent, landlord, mortgage lender or Insurance Agent?(Required)
Do you have a family member who has been or is currently a Real Estate Agent, landlord, mortgage lender or Insurance Agent?(Required)
Please specify the hours when you are most available for work.(Required)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 

Consent

Regulations promulgated by the United State Department of Housing and Urban Development, "HUD," at 24 C.F.R.§125.107 "Testers", require that any testing activities funded through a grant from HUD under the Fair Housing Initiatives Program, "FHIP", must meet the following requirements:

(a) Testers must receive training or be experienced in testing procedures and techniques.

(b) Testers and the organizations conducting tests, and the employees and agents of these organizations may not:
(1) Have an economic interest in the outcome of the test, without prejudice to the right of any person or entity to recover damages for any cognizable injury;
(2) Be a relative (by blood, adoption, or marriage) of any party in a case;
(3) Have had employment or any other affiliation, within one year, with the person or organization to be tested: or
(4) Be a licensed competitor of the person or organization to be tested in the listing, rental, sale, or financing of real estate.

By signing this Application, I state that I have read the preceding, that I understand my obligations, and that I will comply with the requirements of the regulations.
Please read, complete and initial one of the following clauses(Required)
Clear Signature
Consent(Required)
Clear Signature
MM slash DD slash YYYY
Name(Required)
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2022 Impact Report