Charlotte Housing Authority Form PDF Details

Access to housing is a fundamental right, critically woven into the fabric of social stability and individual dignity. The Housing Authority of the City of Charlotte (CHA) steps into this arena with its public housing application process, an initiative aimed at providing affordable homes to those in need. Through this meticulously designed form, applicants are guided to provide comprehensive personal and financial information, from basic identifiers like name and address, to more complex details concerning income, family composition, and legal history. By requiring information on race, ethnicity, family type, educational background, and disabilities, the CHA ensures a nuanced approach to housing allocation, considering a broad spectrum of community needs. Applicants must declare any past interactions with federal housing assistance, criminal history related to drug or violent offenses, and any incidents of fraud within federal assistance programs, aligning with the objective to maintain a safe and supportive community environment. The stipulated use of black or blue ink underscores the formality and importance of the application, a gateway to potential housing stability for many. Recognized as both a meticulous intake document and a critical first step toward securing housing, this form embodies the intricate balance between regulatory requirements and the pressing need for housing among Charlotte's residents.

QuestionAnswer
Form NameCharlotte Housing Authority Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namessection 8 housing application, section 8 charlotte nc applications, affordable housing applications, charlotte public housing application

Form Preview Example

CHA OFFICIAL USE ONLY

Date Stamp

 

Housing Authority of City of Charlotte

 

 

 

 

 

ONLINE APPLICATION

 

 

 

 

SITE APPLYING FOR: ____________________________________________

 

 

 

 

Status: Approve

Denied Prospect

 

Intake Processor’s Signature:

 

Bedroom Size:

Program Type:

 

 

 

 

 

 

 

PUBLIC HOUSING APPLICATION

Please do not use a pencil. Please use a black or blue ink pen.

You must be 18 years old in order to submit an application. This application must be filled out completely. Failure to do so will place your application in the incomplete file and it will not be placed on the Waiting List.

 

First Name

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

State

 

 

 

 

 

Zip Code

 

 

 

 

 

 

 

 

Telephone Number (Home)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number (Office/Other)

 

 

 

Social Security #

 

 

 

 

 

 

 

Birth Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Race

 

 

 

 

Ethnicity

Family Type

 

 

 

Highest Education Completed

 

White

 

 

 

 

Hispanic

Family

 

 

 

Elementary

 

 

 

Black/African American

 

 

Non-Hispanic

Disabled (check all that apply)

 

High School

 

 

 

American Indian/Alaska Native

 

 

 

Hearing impaired

 

 

Jr. College

 

 

 

Asian

 

 

 

 

 

 

Sight impaired

 

 

 

College/University

 

Native Hawaiian/Pacific Islander

 

 

 

Mobility impaired

 

Post Graduate

 

 

 

Other

 

 

 

 

 

 

Elderly (62 and older)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Near Elderly (50 – 61)

 

 

 

 

 

 

 

 

 

Type of Monthly Income (check all that apply)

Amount of Monthly Income

 

 

 

 

 

Assets

 

Wage

SS

TANF

SSI

Child Support

 

 

 

 

 

 

 

Savings Stocks, Bonds, Money

 

VA

Retirement/Pension

Unemployment

$_____________________

 

401K

 

Market account

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sex/Gender

 

 

 

 

 

Number Of Adults

 

# Of Children in Family

 

Do you own any pets?

 

Male

Female

 

 

 

in Family

 

 

 

______ girl(s)

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

______ boy(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please specify:

 

Bank Account

 

 

 

 

 

Drivers License #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Occupation

 

 

 

 

 

 

Are you a US citizen?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes (Citizen)

No (Noncitizen)

 

 

 

 

How did you hear about us? (check all that apply) None Sign

Drive By

 

Walk-in

Referral

 

Word of Mouth

 

Yellow pages

Newspaper

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant Signature

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

1.

Have you ever lived in federally subsidized housing?

Yes______ No______

If yes, please give the name of the Housing Authority and address.

_____________________________________________________________________

If you answered yes to #1, please answer #2

2.

Did you leave owing the Housing Authority any money?

Yes______ No______

3.Have you as head of household ever been convicted of a

 

felony for drug-related criminal activity or violent criminal

 

 

 

activity within the last seven(7) years?

Yes______

No______

4.

Has anyone in your household ever been arrested or convicted

 

 

 

of a felony for drug-related criminal activity or violent criminal

 

 

 

activity within the last seven(7) years? If yes, what state did the

 

 

 

offense occur in? Example SC, NC, etc.

Yes______

No______

5.Have you, as head of household, or anyone in your household ever committed any fraud in Federal assistance housing

program, or been requested to repay money for knowingly

 

misrepresenting information for such housing programs, or

 

have you been requested to repay any monies?

Yes______ No______

I do hereby certify that the information I gave is true and accurate, to the best of my knowledge.

_________________________________

_____________________

Applicant’s Signature

Date

Please list the individuals that will be living with you. These persons must be related to

you by blood, marriage or adoption.

Only list the individuals that will actually be living with you.

Name of Members

Relationship

Age

Birth Date

Sex

Social Security Number

 

Head of Household

 

 

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Is any member expecting a baby?________

Which member?________

Due date___________________________

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