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***All changes to income or cash benefits for any household member must be reported within 10
business days of the change in writing on this form.
You will be required to submit supporting documentation of any income change reported. Documentation could be a month of current pay stubs, benefit letter, letter of new employment or termination of employment on employer letterhead, etc… You may submit documentation with this form if available. Your assigned property manager will review your change request and may require additional documentation or an appointment in our offices.
Failure to report an increase within ten (10)business days of the change may be investigated for fraud and will result in a debt owed to the Housing Authority and could also result in termination of assistance.
A increase in household income reported will generate a change in Total Resident Rent for the 1st day of the upcoming month following 30 days, provided all documentation is completed in a timely manner.
• A decrease in household income reported will generate a change in Total Resident Rent for the 1st day of the upcoming month provided all documentation is complete in a timely manner.
• A decrease in household income reported on or by the 22nd of the month will generate a change in Total Resident Rent for the 1st day of the upcoming month.
• A decrease in household income reported on or after the 23rd of the month will generate a change in Total Resident Rent for the 1st day of the month following the upcoming month.
***All requests to add person(s) to the household must be approved by the Housing Authority before the person(s) may reside in the unit.***
Additional ADULT: You may request to add an adult to your household. The requested adult must be eligible under our administrative plan and must provide all requested documentation. An appointment will be scheduled to determine eligibility. The additional adult is NOT to reside in the unit until eligibility has been determined.
Additional CHILD: You may request to add a child to your household under the following conditions: Birth of a new baby to a current household member, legal adoption, court awarded legal custody, foster placement. You will be required to provide documentation.
Remove a Household Member: You will be required to provide documentation to prove the whereabouts of the household member you are requesting to remove.
***If you or anyone in your family is a person with disabilities, and you require a specific accommodation in
order to fully utilize our programs and services, please contact the housing authority.
WARNING: Section 1001 of Title 18 of the US Code makes it a Criminal Offense to make willful false statements or misrepresentations to any department of the US Government, including HUD and any Housing Authority.
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