Additional Adult Certification/Reporting Interim Changes


I have read the Additional Adult Certification/Reporting Interim Changes. 

Additional Adult Certification 

The Fayetteville Housing Authority Policies state that no adult person(s) other than those listed on the lease and application shall live/stay in the unit other than on a temporary basis and/or not exceeding two weeks.  This is to ensure that Gross Family Contribution is accurately based on the total monthly gross income of that household unit.

If this situation should arise during the term of the lease, I agree to contact the Housing Authority with additional information.  I realize that failure to do this could result in an eviction, lifetime loss of the Housing Authority programs, repayment of the rent and possible theft and/or fraud charges under state and federal law.

I understand the above statement.  There is no other adult living/staying in the unit now other than whose name is on the application and lease.  I agree to notify the Housing Authority if this should change.

Reporting Interim Changes

The Fayetteville Housing Authority Policies state that any changes, either in income or household composition (change in family members), must be reported promptly to the Housing Authority.

If this situation should arise during the contract year, I agree to contact the Housing Authority with any change in information.  I realize that failure to do so could result in termination of contract, lifetime loss of the Housing Authority programs, repayment of rent and possible fraud charges under state and federal law.

I understand the above statement.  The information given to the Fayetteville Housing Authority to complete the necessary contract and lease is true and correct.  I understand giving false statements to the Housing Authority is a violation of federal law.

Leave this empty:

Signature arrow
Fayetteville Housing Authority https://fayettevillehousingauthority.org
Signature Certificate
Document name: Additional Adult Certification/Reporting Interim Changes
lock iconUnique Document ID: bd0e943300fb624f0928604c241ce35f56b2ca7e
Timestamp Audit
April 16, 2020 1:05 pm CDTAdditional Adult Certification/Reporting Interim Changes Uploaded by Angela Belford - angela@fayettevilleha.org IP 184.187.228.121