USDA/HUD HOUSING APPLICATION
DO NOT WRITE BELOW THIS LINE. FOR MANAGEMENT USE ONLY
APPLICATION DISPOSITION:
Approved: ________________ Approved by: _______________________________
(Date) (Signature)
Title: ______________________________________
Disapproved: ________________ Disapproved by: ____________________________
(Date) (Signature)
Title: ______________________________________
Reason(s) for Disapproval:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Applicant Notified in Writing on: _______________________________________________________
Applicant Appealed Decision on: ______________________________(Written notification attached)
Applicant Appeal Reviewed by: ____________________________________ Date: ______________
(Signature) (Title)
Appeal Decision:
Approved __________ Disapproved __________
Applicant Notified in Writing on: _________________________________________________
Driver’s License or State‐issued ID __________ Social Security Card __________
Birth Certificate __________ Citizenship __________
Credit, Criminal, and Sex Offender Registry Check __________
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