Fillable Dd Form 1746 - Application For Assignment To Housing printable pdf download

APPLICATION FOR ASSIGNMENT TO HOUSING

1. TYPE SERVICE DESIRED

(X one or both)

(Before completing form, read Privacy Act Statement and Instructions on reverse)

a. MILITARY HOUSING

b. HOUSING REFERRAL

SECTION I - APPLICANT INFORMATION

2. NAME OF SPONSOR

3. PAY GRADE

4. SSN

5. DOD COMPONENT

(Last, First, Middle Initial)

6. ADDRESS

7. TELEPHONE NUMBER

8. STATUS OF APPLICANT

(Street, City, State, Zip Code)

(X one)

HOME (Area Code)

b. DUTY (DSN)

a. MILITARY MEMBER

c. CIVILIAN

b. MILITARY SPOUSE

d. FOREIGN NATIONAL

9. MARITAL STATUS

10. I AM SEPARATED FROM MY DEPENDENTS

(X one)

a. VOLUNTARILY

b. INVOLUNTARILY

11. I REQUEST HOUSING FOR

SECTION II - MILITARY CAREER INFORMATION

(X one)

(Civilians skip to Item 15.)

14. DATES

a. SELF ONLY

b. SELF AND DEPENDENTS

(Enter in YYMMDD order)

MILITARY APPLICANT

MILITARY SPOUSE

12. INSTALLATION/ORGANIZATION TRANSFERRED FROM

a. EFFECTIVE RANK/RATE DATE

b. ACTIVE DUTY SERVICE COMPUTATION

c. TIME REMAINING ON ACTIVE DUTY

13. INSTALLATION/ORGANIZATION TRANSFERRED TO

d. EFFECTIVE CHANGE IN DUTY STATION

e. REPORT DATE

f. ESTIMATED FAMILY ARRIVAL DATE

SECTION III - DEPENDENT DATA

15. DEPENDENTS RESIDING WITH ME

(If more space is needed, continue on plain paper.)

b. DATE OF BIRTH

e. REMARKS (Handicap, health problems, expected additions to

a. NAME (Last, First, Middle Initial)

c. SEX

d. RELATIONSHIP

(YYMMDD)

family, etc.)

MBR'S DATE OF BIRTH:

SECTION IV - HOUSING DATA

16. COMMUNITY HOUSING DESIRED

(X as applicable)

a. PURCHASE HOUSE

d. RENT HOUSE

g. RENT MOBILE HOME SPACE

j. ROOM AND BOARD

b. PURCHASE CONDOMINIUM

e. RENT APARTMENT

h. SHARE

k. SUBLET

c. PURCHASE MOBILE HOME

f. RENT MOBILE HOME

i. RENT ROOM

l. TRANSIENT

18. DATE HOUSING NEEDED

19. PRICE RANGE

17. AMENITIES DESIRED

(X as applicable. Write number in d. and e.)

(YYMMDD)

(Community Housing)

a. FURNISHED

e. NO. BATHS

b. UNFURNISHED

f. PETS (Allowed)

20. LOCATION PREFERENCE

(Community Housing)

c. AIR CONDITIONING

g. OTHER (Explain)

d. NO. BEDROOMS

21. REMARKS

I give the AF Housing Office authorization to release my privacy act information to the Property Management Company to assist in their efforts to

provide their housing services to me._______

Personal email address ________________________________________________

Work email address __________________________________________________

Additional phone number ______________________________________________

22. SIGNATURE OF APPLICANT

23. DATE SUBMITTED

(YYMMDD)

SECTION V - DISPOSITION

(To be completed by the Housing Office.)

24. MILITARY HOUSING

APPLICATION RECEIVED

c. DD FORM 1747 PROVIDED

HOUSING AVAILABILITY (Boxes

b. APPLICATION EFFECTIVE (YYMMDD)

(YYMMDD and time)

(YYMMDD)

indicated on DD Form 1747)

APPLICANT PLACED ON WAITING LIST

f. EFFECTIVE PLACEMENT (YYMMDD)

g. BEDROOMS REQUIRED

DATE UNIT ASSIGNED (YYMMDD)

SECTION VI - HOUSING REFERRAL CERTIFICATE

On this date I have received a listing of the housing restrictions approved

In addition, if any facility refuses to rent or sell to me or I have

by the Installation Commander, and I will not reside in any property on the

reason to believe I am being discriminated against, I will promptly notify

restricted list.

I have been briefed on (1) the services provided by the

the Housing Office.

Housing Office, (2) the DoD program on equal opportunity for military

25. SIGNATURE OF APPLICANT

26. DATE SIGNED

personnel in off-base housing, and (3) nondiscrimination based on physical

(YYMMDD)

or mental handicaps.

DD Form 1746, SEP 93

Previous editions may be used.

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Dd Form 1746 - Application For Assignment To Housing

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