HAO PROPERTIES PRE-APPLICATION

HAO PROPERTIES PREAPPLICATION
Applying for (Check ALL THAT APPLY)*

ALL HOUSING LISTSSECTION 8 (Housing Choice Voucher)PROJECT- BASED VOUCHER SUBSIDIZED Apartments (One combined list for Churchill Park, Smith Homes,Walker Place, Baker Place, Adams Village, and Locke Apartments)
Please answer every question. If a question does not apply to your situation, write N/A to ensure all questions have been answered. Thank you for your cooperation, we look forward to assisting you.
CURRENT ADDRESS

If HOMELESS provide address where you receive mail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Home phone if cell phone is not available
Other Phone
If applicable
Email Address*
example@example.com
Alternate Contact (Phone Number & Name)

HOUSEHOLD MEMBERS

ALL BLANKS MUST BE COMPLETED FOR EACH MEMBER. *Race (Information on race is for statistical purposes only):
Head of Household

HEAD OF HOUSEHOLD refers to the name used for filing purposes
Last Name, First Name, Middle Initial*
Name as it appears on Social Security Card
Sex (M/F)*
Date of Birth*

MonthDayYear
Date
Social Security Number*
Full Time Student? (Y or N)*
Race: *
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer.
Additional Adult

Age 18 or Older
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Additional Adult

Age 18 or Older
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Additional Adult

Age 18 or Older
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Children - Child 1

Newborn to Age 17
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Children - Child 2

Newborn to Age 17
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Children - Child 3

Newborn to Age 17
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Children - Child 4

Newborn to Age 17
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer
Children - Child 5

Newborn to Age 17
Last Name, First Name, Middle Initial
Name as it appears on Social Security Card
Sex (M/F)
Date of Birth

MonthDayYear
Date
Relation to Head
Social Security Number
Full Time Student? (Y or N)
Race:
1. White, 2. Black, 3. American Indian/Alaskan Native, 4. Asian, 5. Pacific Islander, 6. Bi/Multi Racial 7. Prefer not to answer

STATEMENT OF NEED FOR APPLICATION ASSISTANCE
I certify that I have not requested and do not have a need for an interpreter, special apparatus, or any other type of assistance in order to properly complete the application process. I understand that I may ask for assistance at any time during the application process.
Signature - Head of Household

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Signature - Other Adult

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I request the following assistance in order to properly complete the application process:

INTERPRETER (LANGUAGE NEEDED)SPECIAL APPARATUSOther
Signature - Head of Household [IF REQUESTING ASSISTANCE, OTHERWISE LEAVE BLANK]*

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Signature - Other Adult

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RELEASE OF INFORMATION FORM
HUD regulations and Housing Authority policy require staff to verify certain information in order to determine eligibility for initial and continued occupancy in subsidized housing. The types of information which may be needed can include past, present, and future employment, rental history, criminal history, citizenship and immigration status, information on income, assets and deductions, ages of household members, custody of children, verifications of identity and relationship to other family members, marital status, and other information which may be necessary to determine eligibility for housing.

Examples of sources, which may be contacted, include, but are not limited to, the following:
- Kentucky Pre-Trial Services
- Law Enforcement Agencies including NCIC
- IRS, State Wage Agencies
- Banks and other Financial Institutions
- Child Support Division
- Courts
- Credit Bureaus
- Landlords, Past and Present
- Friends, Relatives, other References
- Social Security Administration
- Welfare Agencies
- Immigration and Naturalization Service
- Post Office
- Probation and Parole Officers
- Educational Institutions
- Utility Companies
- Veteran’s Administration
- Employers
Other Providers of: Alimony, Child Support, Child Care, Credit, Medical Care or Equipment, Insurance, Pensions, Annuities, Assets, Income, Unemployment, Informal Support.

I hereby give permission for the sources listed above to release information necessary to the Housing Authority in order to determine my eligibility and rent due under the program. This authorization form does not expire.
Head of Household*

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Other Adult Household Member

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Other Adult Household Member

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Other Adult Household Member

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Other Adult Household Member

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Required Documents
**The below documents are REQUIRED; Your name WILL NOT be added to the waiting list if you fail to provide all required documents.**

• Birth Certificate for MINORS only
• Photo ID for ALL adult household members.
• Social Security Cards for ALL household members

Please upload the documents below.

Completed pre-applications for housing, along with pre-application documents, can be submitted online by visiting www.owensborohousing.org, dropped off (in the office or in the Night Deposit box outside the door), emailed to apps@owensborohousing.org, or mailed to the office.

Normal business hours are Monday – Thursday, 7:30 a.m. – 4:00 p.m. and closed for all major holidays.
File Upload*

Cancelof
Should be Empty:

HAO PROPERTIES PREAPPLICATION

CURRENT ADDRESS

HOUSEHOLD MEMBERS

Head of Household

Additional Adult

Additional Adult

Additional Adult

Children - Child 1

Children - Child 2

Children - Child 3

Children - Child 4

Children - Child 5

Household Income Sources

Other

The following questions are OPTIONAL

PLEASE BE SURE YOU HAVE ANSWERED ALL QUESTIONS

STATEMENT OF NEED FOR APPLICATION ASSISTANCE

RELEASE OF INFORMATION FORM

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING [OPTIONAL]

Required Documents