Section 8 Application Form

Section 8 Application Form

The Section 8 Application form, also known as the Housing Choice Voucher (HCV) application, is a crucial document for families seeking assistance in securing affordable housing. This program aims to ensure that very low-income households can find safe and decent living conditions while paying a portion of their income toward rent and utilities. Completing this application accurately is essential for qualifying for the program and receiving the necessary support.

Access Section 8 Application Here

The Section 8 Application form, officially known as the Housing Choice Voucher (HCV) application, serves as a critical gateway for individuals and families seeking affordable housing assistance in New Hampshire. This program is designed to help very low-income households secure safe and decent living conditions. When completing the application, applicants must provide detailed information about their household, including names, relationships, and income levels. They also need to verify Social Security numbers for all members and demonstrate compliance with various eligibility criteria, such as income limits and citizenship status. The application process is thorough; it requires applicants to answer all questions completely, as any omissions or inaccuracies can lead to denial of assistance. Additionally, preferences related to special circumstances, such as disability or military service, can influence an applicant's position on the waiting list. Understanding the importance of timely communication, applicants are encouraged to report any changes in their contact information while they await their voucher. Overall, the Section 8 Application form is not just a bureaucratic requirement; it is a vital tool that connects families with the resources they need to secure stable housing and improve their quality of life.

Common Questions

What is the Section 8 Housing Choice Voucher?

The Section 8 Housing Choice Voucher Program aims to provide safe, decent, sanitary, and affordable housing to very low-income households. Eligible households contribute a portion of their adjusted income toward rent and utilities, while New Hampshire Housing pays the remaining amount directly to the landlord. The selected rental unit must meet specific housing quality standards. The estimated waiting time for a voucher depends on various factors, including the number of applicants on the waiting list and the availability of vouchers.

What are the eligibility requirements for the Housing Choice Voucher Program?

To qualify for the Housing Choice Voucher Program, applicants must meet several criteria. Annual income must not exceed 50% of the area median income limit. All household members must provide verification of their Social Security numbers. Applicants must also meet HUD requirements regarding immigration or citizenship status and must not owe any money to New Hampshire Housing or any other housing authority. Additionally, applicants must not be subject to lifetime sex offender registration and must not have household members engaged in criminal activities that threaten the safety and well-being of others.

How do I complete the Section 8 Application form?

Completing the application form requires answering all questions without leaving any blank. If a question does not apply, write "none." All Yes or No questions must be marked appropriately. The legal head of household and spouse or co-head must sign and date the application. By signing, applicants confirm that the information provided is accurate and complete. Misrepresentation may lead to denial or termination of assistance. If confirmation of application submission is not received within 30 days, it is advisable to call New Hampshire Housing.

What should I do if my contact information changes while on the waiting list?

If your contact information changes while you are on the waiting list, it is crucial to notify New Hampshire Housing immediately. The waiting list is updated annually, and failure to provide updated contact information may result in your application being inactivated. If you cannot be contacted, you will need to reapply for the program.

What is a Reasonable Accommodation, and how can I request one?

A Reasonable Accommodation is designed to provide individuals with disabilities equal opportunities to participate in the Housing Choice Voucher program. New Hampshire Housing is committed to making reasonable accommodations unless it would cause undue hardship. If you need to request an accommodation, you can do so by contacting New Hampshire Housing. Requests will be addressed within 30 days. Various methods are available to obtain a Reasonable Accommodation Request form, including phone calls, written requests, and online submissions.

How can I contact New Hampshire Housing for more information?

For additional questions or information, you can contact New Hampshire Housing by calling 1-800-439-7247 or 603-310-9390. Email inquiries can be sent to rentinfo@nhhfa.org. For individuals who are hard of hearing, TTY services are available at 603-472-2089 or the NH Relay Number: 711. Spanish-speaking individuals can reach out at 800-676-4290.

Key takeaways

Understanding the Section 8 Application is crucial for those seeking housing assistance through the Housing Choice Voucher Program. Here are some key takeaways to keep in mind:

  • Complete the Application Fully: Every question on the application form must be answered. Leaving questions blank can delay your application. If a question does not apply to you, simply write “none.”
  • Eligibility Requirements: To qualify for the program, your household income must not exceed 50% of the area median income. Additionally, you must provide Social Security numbers for all household members and meet specific immigration or citizenship criteria.
  • Report Changes Promptly: While on the waiting list, if your contact information changes, notify New Hampshire Housing immediately. Failure to do so may result in your application being inactivated.
  • Signatures Matter: The head of household and spouse or co-head must sign and date the application. By signing, you affirm that all information is accurate and complete, which is essential for your eligibility.
  • Know Your Preferences: Certain preferences can affect your place on the waiting list. Be sure to check any preferences that apply to your household, as they may expedite your application process.

Form Properties

Fact Name Details
Program Purpose The Section 8 Housing Choice Voucher Program aims to provide safe and affordable housing for very low-income households.
Income Limit To qualify, your annual income must not exceed 50% of the area median income limit.
Verification Requirements Applicants must provide Social Security numbers for all household members and meet immigration or citizenship requirements.
Waiting List The estimated waiting time for a voucher depends on the number of people on the waiting list and the availability of vouchers.
Application Process All questions on the application must be answered. If a question does not apply, write “none.”
Changes in Contact Information Applicants must notify New Hampshire Housing of any changes to their contact information while on the waiting list.
Reasonable Accommodation New Hampshire Housing will make reasonable accommodations for individuals with disabilities unless it causes undue hardship.
Criminal Activity Restrictions Applicants cannot have household members engaged in criminal activities that threaten the safety or peaceful enjoyment of other residents.

Misconceptions

Misconception 1: The Section 8 application is only for families with children.

This is incorrect. The Section 8 Housing Choice Voucher Program is available to all very low-income households, regardless of family composition. This includes single individuals, couples, and families with or without children. Eligibility is primarily based on income and other qualifying criteria.

Misconception 2: Once you apply for Section 8, you will receive assistance immediately.

In reality, there is often a waiting list for the Housing Choice Voucher Program. The estimated waiting time can vary based on the number of applicants and the availability of vouchers. Many applicants may wait several months or even years before receiving assistance.

Misconception 3: Providing false information on the application will not have serious consequences.

This belief is misleading. Any misrepresentation or failure to disclose information on the application can lead to denial or termination of assistance. It is crucial for applicants to provide accurate and complete information to avoid jeopardizing their eligibility.

Misconception 4: You can skip questions on the application if they do not apply to you.

Applicants should not leave any questions blank. If a question does not apply, it is advised to write “none.” All questions must be answered to ensure the application is complete and can be processed without delays.

Section 8 Application Preview

Housing Choice Voucher (HCV) Section 8 Application

What is the Section 8 Housing Choice Voucher?

The goal of the Federal Housing Choice Voucher Program (Section 8) is to provide safe, decent, sanitary, and affordable housing to very low-income households. Through the program, a qualified household pays a portion of their adjusted income toward rent and utilities, and New Hampshire Housing pays the remainder directly to the landlord. The rental unit is selected by the household and must meet certain housing quality standards.

The estimated waiting time for a voucher is based on the number of people on the waiting list, the availability of vouchers, and an applicant’s preference status.

To qualify for the HCV Program, you must

Have an annual income that does not exceed 50% of the area median income limit. HUD Income Limits https://www.nhhfa.org/rental-assistance/housing-choice-voucher-program/apply/

Provide verification of Social Security numbers for all household members.

Meet HUD requirements for immigration or citizenship status.

Pay any money you owe to New Hampshire Housing or any other housing authority.

Sign authorization forms so that New Hampshire Housing can verify your eligibility requirements for the rental assistance programs.

Not be subject to lifetime sex offender registration requirements.

Not have any household members who are engaged in any criminal activity that threatens the life, health, safety, or right to peaceful enjoyment of the premises by other residents.

Not have any household member who is engaged in any drug-related or violent criminal activity.

Please note that the information provided is subject to verification through computer matching with other federal agencies for the purpose of locating delinquent debtors. The debtor records include: Social Security number, claim number, program code, and indication of indebtedness. Categories of records include, records of claims and defaults, repayment agreements, credit reports, financial statements, and records of foreclosures.

Questions? Contact Us.

Call:

1-800-439-7247 or 603-310-9390

Email:

rentinfo@nhhfa.org

TTY/Relay:

603-472-2089 or the NH Relay Number: 711; TTY or Voice: 711 or

 

800-735-2964 (English) or 800-676-3777 (Español).

Español:

800-676-4290.

Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

Completing the application

Answer all questions on the application form.

o Do not leave any questions blank.

o If a question does not apply to you, write “none.” o All Yes or No questions must be checked (√).

o Refer to the page of preferences and special programs because they can affect the length of wait time.

Unless specifically indicated, all questions in this application apply to all members of the household.

The legal head of household and spouse/co-head must sign and date the application.

oBy signing the application, you swear that all the information is true and complete.

oAny misrepresentation or failure to disclose information may result in denial or termination of assistance.

If you do not receive an application confirmation letter from us within 30 days, call 1-800-439-7247.

Mail your application to

New Hampshire Housing, PO Box 5087, Manchester, NH 03108

Report Changes to your contact information

While you are on the waiting list for a voucher, notify us if your contact information changes. Our waiting list is updated yearly and if we cannot contact you, your application will be inactivated. You will need to re-apply if you cannot be contacted.

Reasonable Accommodation

A Reasonable Accommodation is intended to provide persons with disabilities equal opportunity to participate in the Housing Choice Voucher program through the modification of policies and procedures. New Hampshire Housing is obligated to make an accommodation that is reasonable, unless doing so would result in an undue hardship or fundamental alteration in the nature of the housing program. If you are a person with a disability, and if your request is reasonable, we will try to accommodate your request. New Hampshire Housing will respond to your request within 30 days.

To obtain a Reasonable Accommodation Request form:

Call 1-800-439-7247

People who are hard of hearing can use the TDD line at 603-472-2089 or the NH Relay Number: 711. TTY or Voice: 711 or 800-735-2964 (English) or 800-676-3777 (Español).

Español: 800-676-4290.

Write to New Hampshire Housing, PO Box 5087, Manchester, NH 03108.

Visit our website at: www.nhhfa.org and complete a request form, located in forms and publications https://www.nhhfa.org/rental-assistance/housing-choice-voucher- program/forms-publications/

If you need help filling out a Reasonable Accommodation Request form, or if you would like to submit a request in some other way, please let us know. Any information you provide will be kept confidential.

Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

Application for Housing Choice Voucher

First Name, Middle name, Last Name, and suffix (Jr., Sr., III, etc.)

Social Security Number:

Date of Birth:

 

 

Phone Number:

Email Address:

 

 

Mailing address (street address or PO box, city, state, zip code)

Physical address (if different from mailing address)

Ethnicity: (check one )

Hispanic/Latino □ Non-Hispanic/Latino

Gender:

M □ F

Disabled: Yes

No

Race: (check all that apply )

□ Asian

□ Black/African American

□ American Indian/Alaska Native

□ White

□ Native Hawaiian/Other Pacific Islander

□ Other

Total number of people who will live in your home when you receive a voucher? _______________

List the names and relationship of all people who will live in your unit?

 

1.

Relationship

 

2.

Relationship

 

3.

Relationship

 

4.

Relationship

 

5.

Relationship

 

Number of adult household members over 18? _____

Number of dependents under the age of 18?_____

What is the yearly gross income (before tax) for all household members?

$

Do you speak English?

□ Well □ Not Well □ Not at all

What language do you speak if you do not speak English well?

Are any members of your household subject to lifetime registration under a state sex □ Yes □ No offender law? If yes, name of family member

By Signing below, I certify I understand that the information provided is accurate and complete

Submitting false or misrepresenting information may result in not being eligible for assistance in the Housing Choice Voucher Program.

I need to notify New Hampshire Housing if any information on this application changes.

If I cannot be contacted at the last mailing address given, my name may be removed from the waiting.

Head of Household Signature:

Date:

Spouse, Co-Head, Signature:

Date:

NHHFA use:

FIT TWH Vet DHHS NED MSNONE MSATRISK

MSPSH

FUP FYI E H F Preference: 1 2 3 5 7

BR:

 

 

PBV:

 

BF

MR:

 

 

 

 

 

 

 

 

 

 

 

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Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

Head of Household Name:

SSN# XXX-XX-

Preferences:  Check the preferences that apply to your household.

An approved preference could affect your place on the waiting list.

A member of the household has a terminal illness (death will result within 24 months as verified by a medical professional).

A member of the household is eligible for services through the Choices for Independence Program (CFI).

A member of the household is an individual transitioning out of a nursing home or an institution.

A member of the household currently serves in the US Armed Forces or has been discharged with an honorable discharge or a discharge based on a service-related injury, illness, or disability.

There is a person with disabilities in the household who is over the age of 18 and under 62.

I am a victim of domestic violence, dating violence, sexual assault or stalking.

The household is rent burdened or at risk of becoming homeless because I/we:

pay more than half of my/our gross income toward rent, or

live with friends or relatives. My name is not on the lease. If I were not in this current living arrangement, I would otherwise be homeless, or

am/are temporarily living in a substandard living situation, i.e., campground or other temporary placement.

The household is homeless because I/we:

Lack a fixed, regular, and adequate nighttime residence.

Reside in Permanent Supportive Housing and no longer require intensive services. This program is designed to support the “moving on” of permanent supportive housing tenants who are capable of living in independent community-based housing.

Preferences or Programs that require an agency referral

(Referral is required to qualify for the following)

The household is eligible for transitional housing through FIT or Harbor Homes.

The household is participating in transitional housing through DHHS and they are transitioning from an institution and is in a program receiving case management services through DHHS.

The Household is working with DCYF and qualifies for the Family Unification Program (FUP):

The family is working with DCYF for whom the lack of adequate housing is the primary reason that our children will be placed in out-of-home care or their return is being delayed for that reason, or

I am a youth at least 18 years of age and not yet 25 years of age who left foster care or will leave foster care within 90 days and I am homeless or at risk of becoming homeless, or

Family Youth Independence Program

Mainstream Program: Any person with disabilities in the household over 18 and under 62 who qualifies for a preference within this program because they are:

Transitioning out of institutional or other segregated settings

At serious risk of institutionalization because they lack access to supportive services for independent living, or they would be institutionalized if their services were cut, or

Residents of permanent supportive housing or a rapid rehousing program who have previously

experienced homeless.

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Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

Head of Household Name:

Project Based Property Option

SSN# XXX-XX-

These properties have vacancies from time to time. If you choose to live in one of these units, you will pay 30% of your monthly adjusted income towards rent and utilities. The owner handles tenant selection from a separate waiting list for each property. If you choose to be on the waiting list for one of these properties, it does not affect your placement on the Housing Choice Voucher waiting list.

Properties marked as Elderly are age restricted and applicants must be 62 years of age or over

Check which properties you would like to be notified about when there is a vacancy.

Check any preferences that you qualify for.

Belknap County

Property Information

Bedroom Sizes

 

 

Available

Belmont

□ Sandy Ledge (50)

2 and 3 bedrooms

Gilford

□ Gilford Village Knolls 3 (363) Elderly

1 bedroom

 

Barrier free/accessible

 

Laconia

□ Sunrise House (368) Elderly

1 bedroom

 

Barrier free/accessible

 

 

□ Choices for Independence (CFI)Preference

 

Carroll County

 

 

Conway

□ Conway Pines Senior (344) Elderly

1 and 2 bedrooms

 

Barrier free/accessible

 

Cheshire County

 

 

Hinsdale

□ Hinsdale School (104)

1, 2 and 3 bedrooms

Keene

□ Westmill Senior (345) Elderly

1 bedroom

 

Barrier free/accessible

 

Swanzey

□ West Swanzey Family Housing (41)

1 and 2 bedrooms

Winchester

□ Snow Brook (51)

2 and 3 bedrooms

Coos County

 

 

Berlin

□ Notre Dame Senior Housing (285) Elderly

1 bedroom

 

Barrier free/accessible

 

 

□ Choices for Independence (CFI)Preference

 

Grafton County

 

 

Lebanon

□ Upper Valley Transitional (42)

2 bedrooms

Lebanon

□ Parkhurst Community Housing (351)

1 bedroom

 

Barrier free/accessible

 

 

□ Chronically Homeless Preference

 

 

(attach Upper Valley Haven referral form)

 

 

□ Rent burdened/at risk of becoming homeless

 

Plymouth

□ Bridge House (373)

Single Room Occupancy

 

□ Veteran Preference

 

Hillsborough County

 

 

Amherst

□ Parkhurst Place (37) Elderly

1 bedroom

 

Barrier free/accessible

 

Hudson

□ Friars Court (392)

1 and 2 bedrooms

 

Barrier free/accessible

 

Pelham

□ Pelham Terrace (38) Elderly

1 bedroom

 

Barrier free/accessible

 

 

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Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

Merrimack County

Concord

□ Willow Crossing (45)

2 and 3 bedrooms

Barrier free/accessible

Concord

□ Green Street Apartments (383)

1 bedroom

 

Barrier free/accessible

 

 

□ Homeless Preference (attach Concord Coalition

 

 

to End Homelessness referral form)

 

Rockingham County

 

 

Deerfield

□ Sherburne Woods (44) Elderly

1 and 2 bedrooms

 

Barrier free/accessible (1 bedroom only)

 

Hampton Falls

□ The Meadows (354) Elderly

1 bedroom

 

Barrier free/accessible

 

Strafford County

 

 

Dover

□ Bellamy Mill Apartments (40)

1 and 2 bedrooms

Farmington

□ Mad River Apartments (43)

3 bedrooms

 

Barrier free/accessible

 

Rochester

□ Academy Street Family Housing (387)

2 bedrooms

 

Barrier free/accessible

 

 

□ Homeless Preference (attach Strafford County

 

 

Community Action referral form)

 

Rochester

□ Arthur H. Nickless Jr. Housing for the Elderly

1 bedroom

(357)Elderly

Barrier free/accessible

Rochester

□ Brookside Place (39)

2 bedrooms

Moderate Rehabilitation Property Option

These properties have vacancies from time to time. If you choose to live in one of these units, you will pay 30% of your monthly adjusted income towards rent and utilities. You cannot, however, take your assistance with you if you move out of the property. You may remain on the waiting list while you live in one of these properties. Properties marked as elderly/disabled are available to applicants 62+ or applicants with disabilities under the age of 62.

Check which properties you would like to be notified about when there is a vacancy.

Cheshire County

Property Information

Bedroom Sizes

 

 

Available

Hinsdale

□ Post Office Square (14)

1, 2, and 3 bedrooms

Hinsdale

□ Todd Block (20) Elderly /Disabled

0 and 1 bedrooms

Winchester

□ Keene Road (30)

2 bedrooms

Grafton County

 

 

Bristol

Central Square (24) Elderly /Disabled

1 bedroom

Hillsborough County

Manchester

□ School and Third (9)

2 and 3 bedrooms

Nashua

□ Summer Street (31) Elderly /Disabled

1 bedroom

Merrimack County

Franklin

Central Street (8)

0, 1, 2, and 3 bedrooms

Rockingham County

Raymond

Main St (15) Elderly /Disabled

1 bedroom

Strafford County

Farmington

Crowley St (22)

1 and 2 bedrooms

Sullivan County

Claremont

High Street (29)

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1 bedroom

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Housing Choice Voucher Application |rentinfo@nhhfa.org| 603 310 9390

OMB No. 2577-0266 Expires 04/30/2023

U.S. Department of Housing and Urban Development

Office of Public and Indian Housing

DEBTS OWED TO PUBLIC HOUSING AGENCIES AND TERMINATIONS

Paperwork Reduction Notice: Public reporting burden for this collection of information is estimated to average 7 minutes per response. This includes the time for respondents to read the document and certify, and any recordkeeping burden. This information will be used in the processing of a tenancy. Response to this request for information is required to receive benefits. The agency may not collect this information, and you are not required to complete this form, unless it displays

a currently valid OMB control number. The OMB Number is 2577‐0266, and expires 04/30/2023.

NOTICE TO APPLICANTS AND PARTICIPANTS OF THE FOLLOWING HUD RENTAL ASSISTANCE PROGRAMS:

Public Housing (24 CFR 960)

Section 8 Housing Choice Voucher, including the Disaster Housing Assistance Program (24 CFR 982) Section 8 Moderate Rehabilitation (24 CFR 882)

Project-Based Voucher (24 CFR 983)

The U.S. Department of Housing and Urban Development maintains a national repository of debts owed to Public Housing Agencies (PHAs) or Section 8 landlords and adverse information of former participants who have voluntarily or involuntarily terminated participation in one of the above-listed HUD rental assistance programs. This information is maintained within HUD’s Enterprise Income Verification (EIV) system, which is used by Public Housing Agencies (PHAs) and their management agents to verify employment and income information of program participants, as well as, to reduce administrative and rental assistance payment errors. The EIV system is designed to assist PHAs and HUD in ensuring that families are eligible to participate in HUD rental assistance programs and determining the correct amount of rental assistance a family is eligible for. All PHAs are required to use this system in accordance with HUD regulations at 24 CFR 5.233.

HUD requires PHAs, which administers the above-listed rental housing programs, to report certain information at the conclusion of your participation in a HUD rental assistance program. This notice provides you with information on what information the PHA is required to provide HUD, who will have access to this information, how this information is used and your rights. PHAs are required to provide this notice to all applicants and program participants and you are required to acknowledge receipt of this notice by signing page 2. Each adult household member must sign this form.

What information about you and your tenancy does HUD collect from the PHA?

The following information is collected about each member of your household (family composition): full name, date of birth, and Social Security Number.

The following adverse information is collected once your participation in the housing program has ended, whether you voluntarily or involuntarily move out of an assisted unit:

1.Amount of any balance you owe the PHA or Section 8 landlord (up to $500,000) and explanation for balance owed (i.e. unpaid rent, retroactive rent (due to unreported income and/ or change in family composition) or other charges such as damages, utility charges, etc.); and

2.Whether or not you have entered into a repayment agreement for the amount that you owe the PHA; and

3.Whether or not you have defaulted on a repayment agreement; and

4.Whether or not the PHA has obtained a judgment against you; and

5.Whether or not you have filed for bankruptcy; and

6.The negative reason(s) for your end of participation or any negative status (i.e., abandoned unit, fraud, lease violations, criminal activity, etc.) as of the end of participation date.

08/2013

Form HUD-52675

OMB No. 2577-0266 Expires 04/30/2023

2

Who will have access to the information collected?

This information will be available to HUD employees, PHA employees, and contractors of HUD and PHAs.

How will this information be used?

PHAs will have access to this information during the time of application for rental assistance and reexamination of family income and composition for existing participants. PHAs will be able to access this information to determine a family’s suitability for initial or continued rental assistance, and avoid providing limited Federal housing assistance to

families who have previously been unable to comply with HUD program requirements. If the reported information is accurate, a PHA may terminate your current rental assistance and deny your future request for HUD rental assistance, subject to PHA policy.

How long is the debt owed and termination information maintained in EIV?

Debt owed and termination information will be maintained in EIV for a period of up to ten (10) years from the end of participation date or such other period consistent with State Law.

What are my rights?

In accordance with the Federal Privacy Act of 1974, as amended (5 USC 552a) and HUD regulations pertaining to its implementation of the Federal Privacy Act of 1974 (24 CFR Part 16), you have the following rights:

1.To have access to your records maintained by HUD, subject to 24 CFR Part 16.

2.To have an administrative review of HUD’s initial denial of your request to have access to your records maintained by HUD.

3.To have incorrect information in your record corrected upon written request.

4.To file an appeal request of an initial adverse determination on correction or amendment of record request within 30 calendar days after the issuance of the written denial.

5.To have your record disclosed to a third party upon receipt of your written and signed request.

What do I do if I dispute the debt or termination information reported about me?

If you disagree with the reported information, you should contact in writing the PHA who has reported this information about you. The PHA’s name, address, and telephone numbers are listed on the Debts Owed and Termination Report.

You have a right to request and obtain a copy of this report from the PHA. Inform the PHA why you dispute the information and provide any documentation that supports your dispute. HUD's record retention policies at 24 CFR Part 908 and 24 CFR Part 982 provide that the PHA may destroy your records three years from the date your participation in the program ends. To ensure the availability of your records, disputes of the original debt or termination information must be made within three years from the end of participation date; otherwise the debt and termination information will be presumed correct. Only the PHA who reported the adverse information about you can delete or correct your record.

Your filing of bankruptcy will not result in the removal of debt owed or termination information from HUD’s EIV system. However, if you have included this debt in your bankruptcy filing and/or this debt has been discharged by the bankruptcy court, your record will be updated to include the bankruptcy indicator, when you provide the PHA with documentation of your bankruptcy status.

The PHA will notify you in writing of its action regarding your dispute within 30 days of receiving your written dispute. If the PHA determines that the disputed information is incorrect, the PHA will update or delete the record. If the PHA determines that the disputed information is correct, the PHA will provide an explanation as to why the information is correct.

This Notice was provided by the below-listed PHA:

I hereby acknowledge that the PHA provided me with the Debts Owed to PHAs & Termination Notice:

Signature

Date

Printed Name

08/2013

Form HUD-52675

OMB Control # 2502-0581

Exp. (02/28/2019)

Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING

This form is to be provided to each applicant for federally assisted housing

Instructions: Optional Contact Person or Organization: You have the right by law to include as part of your application for housing, the name, address, telephone number, and other relevant information of a family member, friend, or social, health, advocacy, or other organization. This contact information is for the purpose of identifying a person or organization that may be able to help in resolving any issues that may arise during your tenancy or to assist in providing any special care or services you may require. You may update, remove, or change the information you provide on this form at any time. You are not required to provide this contact information, but if you choose to do so, please include the relevant information on this form.

Applicant Name:

Mailing Address:

Telephone No:

Cell Phone No:

Name of Additional Contact Person or Organization:

Address:

Telephone No:

Cell Phone No:

 

 

 

 

E-Mail Address (if applicable):

 

 

 

 

 

 

 

Relationship to Applicant:

 

 

 

 

 

 

 

Reason for Contact: (Check all that apply)

 

 

 

Emergency

Assist with Recertification Process

Unable to contact you

Change in lease terms

Termination of rental assistance

Change in house rules

Eviction from unit

Other:

______________________________

 

Late payment of rent

 

 

 

Commitment of Housing Authority or Owner: If you are approved for housing, this information will be kept as part of your tenant file. If issues arise during your tenancy or if you require any services or special care, we may contact the person or organization you listed to assist in resolving the issues or in providing any services or special care to you.

Confidentiality Statement: The information provided on this form is confidential and will not be disclosed to anyone except as permitted by the applicant or applicable law.

Legal Notification: Section 644 of the Housing and Community Development Act of 1992 (Public Law 102-550, approved October 28, 1992) requires each applicant for federally assisted housing to be offered the option of providing information regarding an additional contact person or organization. By accepting the applicant’s application, the housing provider agrees to comply with the non-discrimination and equal opportunity requirements of 24 CFR section 5.105, including the prohibitions on discrimination in admission to or participation in federally assisted housing programs on the basis of race, color, religion, national origin, sex, disability, and familial status under the Fair Housing Act, and the prohibition on age discrimination under the Age Discrimination Act of 1975.

Check this box if you choose not to provide the contact information.

Signature of Applicant

Date

The information collection requirements contained in this form were submitted to the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The public reporting burden is estimated at 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Section 644 of the Housing and Community Development Act of 1992 (42 U.S.C. 13604) imposed on HUD the obligation to require housing providers participating in HUD’s assisted housing programs to provide any individual or family applying for occupancy in HUD-assisted housing with the option to include in the application for occupancy the name, address, telephone number, and other relevant information of a family member, friend, or person associated with a social, health, advocacy, or similar organization. The objective of providing such information is to facilitate contact by the housing provider with the person or organization identified by the tenant to assist in providing any delivery of services or special care to the tenant and assist with resolving any tenancy issues arising during the tenancy of such tenant. This supplemental application information is to be maintained by the housing provider and maintained as confidential information. Providing the information is basic to the operations of the HUD Assisted-Housing Program and is voluntary. It supports statutory requirements and program and management controls that prevent fraud, waste and mismanagement. In accordance with the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information, unless the collection displays a currently valid OMB control number.

Privacy Statement: Public Law 102-550, authorizes the Department of Housing and Urban Development (HUD) to collect all the information (except the Social Security Number (SSN)) which will be used by HUD to protect disbursement data from fraudulent actions.

Form HUD- 92006 (05/09)

Language Assistance Services

ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-800-439-7247.

Español (Spanish) ATENCIÓN: Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están a su disposición. Llame al 1-800-439-7247.

Português (Portuguese) ATENÇÃO: Se você fala português, encontram-se disponíveis serviços linguísticos gratuitos. Ligue para 1-800-439-7247.

Kreyòl Ayisyen (French Creole) ATANSYON: Si nou palé Kreyòl Ayisyen, gen asistans pou sèvis ki disponib nan lang nou pou gratis. Rele 1-800-439-7247.

繁體中文 (Traditional Chinese) 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-800-439-7247.

Tiếng Việt (Vietnamese) CHÚ Ý: Nếu quí vị nói Tiếng Việt, dịch vụ thông dịch của chúng tôi sẵn sàng phục vụ quí vị miễn phí. Gọi số 1-800-439-7247.

Русский (Russian) ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги

перевода. Звоните 1-800-439-7247.

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ﺔﯾﺑرﻌﻟا (Arabic)

1-800-439-7247

ﻰﻠﻋ ﻞﺼﺗإ ً ﺎﻧﺎﺠﻣ ﻚﻟ ةﺮﻓﻮَﺘﻣ

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ُ

ﺔﯾﻮَﻐﻠﻟأ ةﺪﻋﺎﺴﻤﻟأ تﺎﻣَﺪﺧَ ، ﺔﯿﺑﺮﻌﻟأ ِ ﺔﻐﻠﻟأ ﻢﻠﻜﺘﺗ ﺖﻧأ اذإ :هﺎﺒﺘﻧإ

 

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َ

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ខ្មែរ(Cambodian) រស្ ជូនដណឹង៖ ប

ើអ្នកនិយយែ ្ ្មរ, បយយើងមកែម្កខ្ ជូនប បោកអ្នកបោយ

ឥតគិតៃ្ ្ល។។ ចូរ ទូរស័ព្ទ1-800-439-7247

 

 

 

 

 

 

Français (French) ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-439-7247.

Italiano (Italian) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-800-439-7247.

한국어 (Korean) '알림': 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

1-800-439-7247. 번으로 전화해 주십시오.

ελληνικά (Greek) ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, υπάρχουν στη διάθεσή σας δωρεάν υπηρεσίες γλωσσικής υποστήριξης. Καλέστε 1-800-439-7247.

Polski (Polish) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-800-439-7247.

ह िंदी(Hindi) ध्यान

: अगर आप ह िंदी बोलतेैंतो आपके ललयेभाषाकी स ायता उपलब्ध ै.

जानकारी के ललयेफोन करे. 1-008 -439-7247.

ພາສາລາວ (Lao) ໂປດຊາບ:

າວາ າ ວາພາສາ ລາວ, າ ບລ າ ຊວ

ດາ ພາສາ, ໂດ ບ ສ າ,

າ . ໂ

1-008 -439-7247.

 

Check out Other PDFs

Common mistakes

  1. Leaving Questions Blank: It is crucial to answer all questions on the application form. Leaving any question unanswered can lead to delays or even denial of your application.

  2. Failing to Provide Required Documentation: Ensure that you provide verification of Social Security numbers for all household members. Missing documentation can hinder the processing of your application.

  3. Not Reporting Changes: If your contact information changes while on the waiting list, notify New Hampshire Housing immediately. Failing to do so may result in your application being inactivated.

  4. Misunderstanding Household Members: Remember that all questions generally apply to all members of the household. Ensure that you include information for everyone living in your home.

  5. Incorrectly Filling Out Income Information: Provide accurate yearly gross income for all household members. Inaccurate information can lead to disqualification from the program.

  6. Not Signing the Application: The legal head of household and spouse or co-head must sign and date the application. A missing signature can result in processing delays.

  7. Ignoring Preferences and Special Programs: Review the preferences and special programs section carefully. These can affect your place on the waiting list, so be sure to check any that apply to your household.

  8. Providing Inaccurate Information: Ensure that all information is truthful and complete. Misrepresentation can lead to denial or termination of assistance.

  9. Not Following Up: If you do not receive an application confirmation letter within 30 days, reach out to New Hampshire Housing. Taking this step can help avoid unnecessary delays.

Dos and Don'ts

Things to Do:

  • Answer all questions on the application form completely.
  • Provide verification of Social Security numbers for all household members.
  • Sign and date the application to confirm the accuracy of the information provided.
  • Notify New Hampshire Housing if your contact information changes while on the waiting list.

Things Not to Do:

  • Do not leave any questions blank; if a question does not apply, write “none.”
  • Do not misrepresent any information on the application.
  • Do not forget to check all Yes or No questions.
  • Do not fail to contact New Hampshire Housing if you do not receive an application confirmation letter within 30 days.

Similar forms

The Section 8 Application form shares similarities with the Low-Income Housing Tax Credit (LIHTC) application. Both documents aim to assist low-income households in securing affordable housing. The LIHTC application requires detailed income information and household composition, much like the Section 8 form. Applicants must demonstrate their eligibility based on income limits and provide documentation to verify their financial status. Both applications also emphasize the importance of accurate and truthful information, as misrepresentation can lead to disqualification.

Another document akin to the Section 8 Application is the Public Housing Application. This form is used by individuals seeking to reside in public housing units managed by local housing authorities. Similar to Section 8, the Public Housing Application requires applicants to provide personal and financial information to establish eligibility. Both applications prioritize low-income families and individuals, and they often involve waiting lists, making timely communication about changes in contact information crucial for applicants.

The Continuum of Care (CoC) application also resembles the Section 8 Application in its focus on providing housing assistance to vulnerable populations, including those experiencing homelessness. The CoC application assesses an applicant's needs and eligibility for various housing programs, much like the Section 8 process. Both applications require documentation of income and household composition, and they aim to connect applicants with appropriate housing resources based on their specific circumstances.

Similarly, the Emergency Housing Voucher (EHV) application serves individuals in urgent need of housing assistance. This document is designed to quickly connect eligible households with rental assistance, similar to the expedited process found in the Section 8 Application. Both forms require applicants to disclose income and household details while ensuring that they meet specific eligibility criteria, particularly in relation to income thresholds and housing quality standards.

The Tenant-Based Rental Assistance (TBRA) application is another document comparable to the Section 8 Application. TBRA programs provide rental assistance to low-income households, allowing them to choose their housing while receiving support. Like the Section 8 Application, the TBRA application requires detailed income information and household composition. Both documents also mandate that applicants disclose any criminal history or debts owed to housing authorities, ensuring that only eligible individuals receive assistance.

The Housing Opportunities for Persons With AIDS (HOPWA) application also shares similarities with the Section 8 Application. HOPWA provides rental assistance to individuals living with HIV/AIDS, focusing on their specific housing needs. Both applications require detailed income verification and household information, and both prioritize low-income individuals. The emphasis on confidentiality and the need for accurate information is a common thread, as both programs aim to provide essential support to their respective populations.

Additionally, the Rural Development (RD) housing application is similar to the Section 8 Application in its goal of providing affordable housing to low-income families in rural areas. The RD application assesses household income and composition, similar to the Section 8 process. Both applications focus on ensuring that applicants meet specific income limits and housing standards, fostering an inclusive approach to housing assistance.

In the realm of assistance programs, the Employment Application PDF form stands out as an essential tool for job seekers who wish to provide their personal information, work history, and qualifications to potential employers. This form is critical in the hiring process, enabling candidates to effectively showcase their skills and experiences. For those looking for various application forms, including the Employment Application PDF, resources like Top Forms Online can be invaluable, helping to enhance the chances of securing job interviews through well-completed submissions.

The Veterans Affairs Supportive Housing (VASH) application is another document that parallels the Section 8 Application. VASH provides rental assistance to homeless veterans, combining housing support with case management services. Like the Section 8 Application, the VASH application requires income verification and household information. Both documents aim to address the unique needs of their target populations while ensuring compliance with federal guidelines.

Finally, the Family Unification Program (FUP) application shares commonalities with the Section 8 Application as it seeks to provide housing assistance to families involved with child welfare services. Both applications require detailed income and household information, emphasizing the importance of stable housing for family reunification. The FUP application also includes specific eligibility criteria related to child welfare, similar to the preferences outlined in the Section 8 Application.