Section 8 Application Template - Emery County, Utah Page 3
Download a blank fillable Section 8 Application Template - Emery County, Utah 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 Section 8 Application Template - Emery County, Utah 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
4EMERY COUNTY HOUSING AUTHORITY
PO Box 551 / 75 E Main St., Castle Dale, UT 84513 (435) 381-2902
Application for Section 8
(please print legibly and use ink)
I Contact Information
_______________________________________
_____________________________________
Name of head of Family
Name of Spouse or Co-head
_________________________
______________________________________ ______________________
Mailing Address (PO Box)
email address
Telephone Number
__________________________________________________________________________________________
Street Address
City
State
Zip Code
II Household Members and Income - List all persons who live with you, including yourself.
Name
Social Security #
Sex
Age
Date of Birth
Relationship
HEAD
List names and addresses of all sources if income for all household members, and the GROSS amounts
received. Include all income from employment, child support, TANF, social security, unemployment, pensions,
tips, GI Benefits, school grants, and all other sources of income.
Household Member
Source of Income and Address
Income
How Often
Amount
Race:
White_______Black_______American Indian_______Asian/Pacific Islander_______Other_________
Ethnicity: (Check One) Hispanic_________ Non-Hispanic_________
Is any member of your family handicapped or disabled?____________________________________________
Do you expect any changes in family size? If yes, Please explain______________________________________
Do you receive payment for Child Support?____________ Alimony?___________ Child Care?____________
Does your family have unusually high medical expenses not covered by insurance? ______________________
Do you pay for child care so that you can go to work or attend school? __________ State Assisted?__________
III Assets:
Do you have any Savings Accounts, Savings Bonds, or Life Insurance with a cash value? __________________
Do you own a home, Real Estate, Mobile Home or other asset? ______________________________________
Have you sold or disposed of Assets or Real Estate in the past two years? __________ If yes, explain on back.
IV Priorities
Are you a family who is required to move through no fault of your own?_______________________________
Are you paying more than 50% of your income for rent and utilities? __________________________________
Are you living in (or renting) a place of your own? ________________________________________________
What is the monthly amount your are now paying for Rent?_________ Utilities? (not including phone) ______
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business