Supplement To Application For Federally Assisted Housing Template Page 10
Download a blank fillable Supplement To Application For Federally Assisted Housing Template in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Supplement To Application For Federally Assisted Housing Template with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10Housing Suitability Screening
Previous housing references:
List the address and landlord information (if applicable) for the last five (5) years. Attach additional sheet if necessary.
We cannot process the application without this information.
Rent/Own/
Landlord, Home
Landlord, Home
Address
From
To
Live With
Owner Name,
Owner Telephone
(Include Street, City, State)
Month/Year
Month/Year
Someone/Other
even if you were
Number
not on a lease
For All adult members over 18 years of age, please list their name, address, City, State, then the Zip Code that they have
lived in for the last five (5) years. Attach additional sheet if necessary.
Name
Address
City
State
Zip Code
Have you or any other household member ever been evicted? Yes No
If Yes: By Whom?__________________________ When?_________________
Why?_____________
For ALL adult members age 18 and over, please read, sign, and date the following: I give my permission for the
Bloomington Housing Authority to conduct a tenancy history check for the past five (5) years. I understand my previous
Landlords will be
contacted.
______________________________________________
___________________________________________
Signature
Date
Signature
Date
_______________________________________________________________
___________________________________________________________
Signature
Date
Signature
Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal