Unit Referral Listing Form - Clearwater Housing Authority

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Clearwater Housing Authority
Unit Referral Listings Form
Please complete this form if you would like to add, modify, or delete a rental property on Clearwater
Housing Authority’s (CHA) Unit Referral Listings. The Unit Referral Listings are issued according to
bedroom size and only to approved Housing Choice Voucher (HCV) Participants or Applicants. These
listings will be updated every two (2) weeks.
A unit will be listed for ninety (90) days. After this time frame, the unit will be removed from the listing
unless a request is made by the owner/landlord to repeat the listing for an additional ninety (90) days. If
the unit listed is leased within the ninety (90) days, you may submit this form to CHA or contact our office
to request removal of the unit from the list. This form may also be used to update information for a unit
that is currently listed.
This form may be faxed to our office at (727) 446-3462, dropped off, or mailed to:
Clearwater Housing Authority
908 Cleveland Street
Clearwater, FL 33755
□ ADD
□ MODIFY
□ DELETE (check one)
Unit Size:
Bedrooms _____________ Baths ________________
Address of Unit: ________________________________________________________
STREET
CITY
ZIP
Proposed Rent: $ _____________
Utilities Included in Rent (check ALL that apply):
□ Water □ Sewer □ Trash □ Gas □ Electric □ None
Owner/Landlord contact name: ____________________________________________
Phone Number: ________________________________
Date Unit is Available: ___________________________
CHA Unit Referral Listings Form 9/2012

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