The information requested in this form is used by the Community Development Office to document your eligibility to participate in the Housing Assistance Program, and in the monitoring of program funds. It will not be disclosed outside of our requirements to determine your eligibility. Certain information (i.e. marital status, race, sex, etc.) is requested solely for the purpose of determining compliance with federal Civil Rights Law. Your response will not affect consideration of your application. The personal information is used for statistical purposes only. Application should be SIGNED and DATED on page 4.
