• Unit Eligibility Request

  • In this form you will be asked questions regarding a unit you are interested in to determine if the unit will qualify based on your voucher size and income.  Please make sure that the information is correct before submitting.

    CIRHA is not responsible for incorrect information.  By signing and submitting the Unit Eligibility Request form, you are confirming that the information you have provided is correct.  Figures used to calculate eligibility will come from this form.

  •  -  -
    Pick a Date

  • NOTICE:

    A move in on the date selected will not be approved as a 30-day notice was not given in a timely manner. This form is NOT a substitution for a 30 day notice. Notices are due on the 1st of the month. A copy of the notice given to the landlord is also required.

  • Utilities

  • On the next page, you will be asked questions regarding the utilities.  It is very important that this information be correct, as it can affect whether or not a unit will work for you.

    You may want to talk to the landlord to make sure you have the right information before submitting your eligibility request. 

    CIRHA is not responsible for obtaining this information for you.

  •  Clear
  • Should be Empty: