Housing Choice Voucher Program - Stratford Housing Authority
Accepting ONLY MAILED applications.
Postmarked between November 12, 2014 and November 14, 2014.
VERY TIGHT WINDOW!!
Monday, November 03, 2014
SEE APPLICATION BELOW Stratford Housing Authority, P.O. Box 488, Stratford, CT 06615 203-375-4483, Ext. 111 or Ext. 117 Preliminary Application (Pre-Application) Section 8 Housing Choice Voucher Program PLEASE PRINT CLEARLY – RETURN ENTIRE FORM The Stratford Housing Authority will use a Random-Draw Lottery System to determine the order of each Pre-Application on the wait list, and a minimum of 300 pre-applications will be drawn. The pre-applications from the lottery will be selected by an independent third party. This form may be reproduced on a copy machine. See Application Below Current Income Limits for admission to the Section 8 Housing Choice Voucher Program are as follows: 1 Person $29,300 5 Persons $45,200 2 Persons $33,500 6 Persons $48,550 3 Persons $37,700 7 Persons $51,900 4 Persons $41,850 8 Persons $55,250 MAIL ONLY completed Pre-Application to: Stratford Housing Authority Section 8 Wait List P.O. Box 488 Stratford, CT 06615 PRE-APPLICATIONS MUST BE POSTMARKED NO EARLIER THAN NOVEMBER 12, 2014 AND NO LATER THAN MIDNIGHT NOVEMBER 14, 2014 ENVELOPES POSTMARKED BEFORE NOVEMBER 12, 2014 AND AFTER NOVEMBER 14, 2014 WILL BE REJECTED • ONLY MAIL-IN PRE-APPLICATIONS WILL BE ACCEPTED. • HAND DELIVERED, E-MAILED, OR FAXED PRE-APPLICATIONS WILL NOT BE ACCEPTED. • INCOMPLETE PRE-APPLICATIONS WILL BE REJECTED. • DUPLICATE APPLICATIONS WILL BE REJECTED. • ONLY ONE PRE-APPLICATION PER POSTMARKED ENVELOPE WILL BE ACCEPTED – MULTIPLE APPLICATIONS PER ENVELOPE WILL BE REJECTED. • ALL INFORMATION WILL BE VERIFIED PRIOR TO THE ISSUANCE OF A VOUCHER. EQUAL HOUSING OPPORTUNITY Se Habla Español
Monday, November 03, 2014
Note: For a more usable copy of this application, go to the United Way of CT Website at www.cthcvp.org, come to the Authority office, or email Maritza Javier at firstname.lastname@example.org NAME (HEAD OF HOUSEHOLD): ______________________________________________________________________ Social Security Number: __________ - __________ - __________ Street Address: _____________________________________________________ Apt. # ____________________ City: ________________________________________ State: ________________ Zip Code: _________________ Date of Birth: ______________________ Age: ____________ Male: ______________ Female: _______________ TOTAL NUMBER OF MEMBERS IN HOUSEHOLD: Please include yourself: ADULTS: Male ____ Female: ____ CHILDREN: Male: ____ Female: ____ ELDERLY: ____ DISABLED: _____ TOTAL HOUSEHOLD GROSS (before taxes) INCOME: _____________________________________________ Race of Head of Household (optional - for HUD Statistical Purposes only): ___ White ___ Black/African-American ___ Asian ___ American Indian/Alaskan Native ___ Native Hawaiian/Pacific Islander Ethnicity of Head of Household (optional - for HUD Statistical Purposes only): ______ Hispanic ______ Non-Hispanic I certify that the above information is accurate and complete. I understand that submission of false information or any misrepresentation may result in loss of eligibility in the Housing Choice Voucher Program and is punishable under Federal Law. _____________________________________________ _____________________________ Head of Household Signature Date Signed
Liberty Community Services, Inc.