Portability Request

Portability Request

For Housing Choice Voucher Moving to Work Families
Head of Household Name: *

First NameMiddle NameLast Name
Email
example@example.com
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Requested Move Date: *

MonthDayYear
Date
Requested Move Jurisdiction:*
Receiving Housing Authority
Reasonable AccommodationEconomic NeedEducational NeedHousehold Need
*External supporting documentation is required for all transfer reasons when available. A letter of explanation may also be attached if needed for clarifying purposes.
Head of Household Signature:*
Description of Attached Supporting Documentation:
Ports will be denied should supporting documentation not be provided. Ports are only granted for the reasons described above. Ports may also be denied should there not be sufficient funds to cover costs of the receiving authority. Applicants issued vouchers who were not residents of Douglas County at the time of application must utilize vouchers for no less than 12 months before becoming eligible for porting. Forms should be submitted to LDCHA’s Initial Occupancy Specialist. This form does not substitute for formal notice to vacate to be coordinated between your landlord and LDCHA Program and Property Management.
Should be Empty: