5301 W. Cypress Street Tampa, FL 33607
This is a preliminary application. Once this pre-application is processed, we will notify you of your status. Qualified applicants will
be scheduled for a full application meeting before being placed on a waiting list. Disqualified applicants will receive a letter detailing
the reasons for denial. Please provide correct mailing address where Tampa Housing Authority may notify you of the status of this
pre-application. Please mail this application to Public Housing Central Intake, 5301 W. Cypress Street, Tampa, FL 33607.
one priority property
: When completing this pre-application process, you are required to select
that you are
interested in applying for. You will be given the opportunity to select more than one property at a later time. Note: Be sure the
property you select has the bedroom size needed for your family composition.
ONLY ONE PRE-APPLICATION PER
ROBLES PARK VILLAGE
3814 CENTRAL AVENUE 33603
NORTH BLVD. HOMES
1129 MAIN ST. 33607
ELDERLY APARTMENTS: (55 years or older)
J.L. YOUNG APARTMENTS
8220 N. FLORIDA AVE. 33604
1515 UNION ST.
SOUTH SCATTERED SITES
ARBORS AT PADGETT ESTATES
4714 S. TRASK AVE. 33611
2801 AZEELE 33609
BAY CEIA APARTMENTS
3422 MACDILL AVENUE 33629
212 S HOWARD AVENUE 33606
ST. LOUIS/ST. CONRAD
2310 ST. LOUIS 33607
NORTH SCATTERED SITES
4706 MUSKOGEE CT. 33610
11201 N 22
5038 TEMPLE HEIGHTS 33617
1314 SLIGH AVENUE 33604
5817 N. ROME AVENUE 33603
C. BLYTHE ANDREWS
2201 E. OSBORNE AVENUE 33610
Last Name: _____________________________ First Name: ______________________MI___ DOB:________________
SS#: _________________________________ Sex: _________ Day/Work Phone: _______________________________
Mailing Address: _____________________________________________City, State, Zip:_________________________
List all other members of the household. Do not include yourself.
Last Name, First Name, MI
Total Monthly Household Income: $___________________
Total Household Members: __________
Have you ever lived in public housing, section 8 or any subsidized housing complex? YES
If so, Where: ______________________ When: ________________Do you owe a balance? ________________
Have you ever been evicted or terminated from public housing, section 8 or any subsidized housing complex? YES NO
If so, Where: __________________________ When: ______________________Why: ____________________
Have you ever been arrested for any of the following criminal activities?
None of the following
Drug Related Activity
Violent Criminal Activity
Warning: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make false statements or
misrepresentation to any department or agency of the U.S. as to any matter within its jurisdiction.
Consent: My signature is the consent which will allow the Tampa Housing Authority to acquire all family members’
criminal record and other necessary information in order to determine my eligibility for public housing.
Applicant Signature: _____________________________________________
Submit by mail or in person only. No Faxed or e-mailed applications accepted. Incomplete pre-applications will not be