Navigating the ups and downs of life's financial roller coaster prompts many to seek support, particularly when it comes to housing stability. In Houston, Texas, a critical resource for those facing such challenges is the Housing Choice Voucher Program's Declaration of Interim Change in Income form, made accessible through the Housing Houston authority. Located at 2640 Fountain View Drive, this program stands as a beacon of hope, offering assistance to individuals and families experiencing shifts in their financial situations. Whether it's a decrease due to loss of employment, changes in benefits like TANF (Temporary Assistance for Needy Families), food stamps, unemployment compensation, child support, or Social Security, or an increase due to new employment or changes in the amount of received benefits, this form serves as a vital tool. By requiring detailed information such as the name, social security number, address, and specific details about the income change including last paychecks, award letters, and contact information for verification, the form ensures a structured and transparent process. This procedure not only facilitates the adjustment of benefits to better match current needs but also underscores the program's commitment to fairness and equality, emblematically supported by its designation as a Fair Housing and Equal Opportunity Agency.
| Question | Answer |
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| Form Name | Housing Houston Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | declaration change income, houston authority form, houston authority change, houston housing authority change income |
2640 Fountain View Drive Houston, Texas 77057 | 713.260.0600 P| 713.260.0547 TTY| www.housingforhouston.com
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Housing Choice Voucher Program |
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DECLARATION OF INTERIM CHANGE IN INCOME |
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Name: |
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Social Security #: |
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Address: |
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Phone #: |
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City, State: |
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To report a decrease in income you must provide the following:
Loss of employment: A copy of your last paycheck and any verification that shows your last day of employment. If you are now receiving regular contributions from someone, you are required to complete a contribution form. If you have been awarded food stamps,TANF, or unemployment compensation please provide a copy of the award letter(s).
For a decrease in TANF benefits, Child Support, Unemployment and Social Security:
Please provide an award letter from the agency indicating the effective date of the change and the new benefit amount. If you have stopped receiving TANF, please provide documentation why you are no longer on the program.
Previous Employer: |
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Last Date of Employment: |
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Contact Person: |
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Address: |
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Phone #: |
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City, Street: |
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Fax #: |
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Zip Code: |
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To report an increase in income please provide the following:
New employment: The address and phone number of someone at the organization who may be contacted to verify your employment and a copy of any check stubs that you have received.
For a new award or receipt of TANF benefits, Child Support, Unemployment, Social Security, SSI, or any other unearned income, you must provide an award letter or other documentation showing the effective date of the benefit and the new benefit amount.
New Employer:
Contact Person:
Phone #:
Fax #:
First Date of Employment:
Address:
City, Street:
Zip Code:
Additional comments:______________________________________________________________________
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Signature of participant:Date:
A Fair Housing and Equal Opportunity Agency
For assistance: Individuals with disabilities may contact the 504/ADA Administrator
at