A Change in Family Composition must be completed for each member being added or removed from the household.

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1 Dear Client: We are committed to processing your Interim Change in Family Composition request in a timely manner. However, all of the required documentation to support the change must be submitted with the request. Change request forms must be complete, signed and legible. We cannot accept requests that are incomplete. Interim Change Request Packets can be submitted in person by mail. If mailing, send only copies, and do not include original documents. Due to processing constraints, we can only provide a status on interim changes that have been submitted at least 30 days prior. Status requests can be submitted via to interim@housingforhouston.com, and we will provide a status via within 3 business days (not including weekends or holidays). Don t forget to check your spam mailbox. Before you allow anyone to move into your unit other than by birth, legal adoption, or court awarded custody, they must be approved by the Houston Housing Authority and your landlord. Failure to receive advance approval from HHA could result in termination of assistance. If you are approved for a Change in Family composition, an approval letter will be mailed to you and to the landlord. If your request has been denied, a denial letter will be mailed to you and your landlord within 30 days. A Change in Family Composition must be completed for each member being added or removed from the household. HHA Interim Change Request Forms and Required Documents 1. Change in Family Composition packet returned with all pages. 2. Request for Change in Family Composition Form must be signed and returned with the required documents. 3. Houston Housing Authority Required Forms o HUD Authorization to Release of Information 9886 (ust be signed by head of household and anyone in household 18 and older) o Criminal Background Check (ust be signed by head of household and new family member being added 18 and older) o 3 rd Party Change in Family Verification Form (Proof of Income verification) o Contribution and Gifts Letter o Declaration Form o Declaration of U.S. Citizenship or Non-Citizens with Eligible Immigration on Status o Household Assets Self Certification Form o Authorization for Release of Information (ust be signed by head of household and anyone in household 18 and older) o Valid Texas photo-identification (Driver s license or state ID) o Birth Certificate o Social Security Card o School Verification Form (If Applicable. ust be filled out by the school with the students schedule included) o Child Care Expenses Verification Form (If Applicable. ust be filled out by the child care provider) Client must attach: 1. All Supporting Documentation 2. Request for Change in Family Composition Packet and Form 3. Houston Housing Authority Required Forms Thank you, HHA staff

2 Request for Change in Family Composition Name of Head of Household Date Client ID # Social Security# Phone Address REOVE from household: (Please provide full name and new address of person being removed) NAE: First and Last NEW ADDRESS: REASON: Please Print ADD to household: (Please provide full name of person being added and complete all fields) NAE: First and Last GENDER REASON: ale Female Relationship to Head of Household Date of Birth: onth/day/ Year Social Security# Does this person have ANY source of income? Yes No Does this person have ANY dependents? Yes No Please attach Supporting documents of proof. If all documents are not provided the request will not be processed. Adding Adding 18 years 18 years or older: or older: Removing over 18 years: Change of of Family Composition Form Form Proof of of Income Change of Family Composition Form Birth Certificate Social Social Security Card Card Declaration Form State picture ID ID (ust be be valid) Criminal Background Form Form Death Certificate / Obituary US Declaration of of Citizenship Form Form Disposal of of Assets form form 1.Copy of updated State ID or utility bill for family member HUD Authorization of of Release of of Information form form removed showing their new address Letter or or new lease from from Owner/anager approving request request AND Adding under 18 years of Age: Lease or letter of HCVP participant from your Owner/anager Change of of Family Composition Form Form Birth Birth Certificate or or Birth Birth facts facts showing removal from household Social Security Card Card US US Declaration of of Citizenship Form Form OR Court Court Awarded Awarded (Notarized (Notarized letter letter or or Power Power of Attorney of Attorney NOT NOT Acceptable) Acceptable) 2.Lease or letter from new Owner/anager of family member removed or statement from the person they are living with. AND Lease or letter of HCVP participant from your Owner/anager Showing removal from household. Signature of Head of Household Removing Under 18 years of Age with Income Change of of Family Composition Form Form Written letter & Proof of of Address (ust (ust provide provide both) both) Proof of Beneficiary change (Child support, SSI, SSI, TANF) TANF) Date Death Certificate // Obituary Removing Under 18 years of Age with no income Change of Family Composition Form Death Certificate / Obituary

3 Housing Choice Voucher Program DECLARATIONS (Please Print) Client s Name: Social Security #: I would like to declare the following: Your Signature Date Your address Your phone #

4 CHANGE IN FAILY COPOSITION --3RD PARTY VERIFICATION CONTACT INFORATION This form must be completed Client Name: Client #: Employment (If applicable) Previous or Current Corporate Company Name: Corporate Company Address: Phone number#: Fax# Address of actual work location: Contributions (If applicable) Contributors Name: Contributors Address: Phone#: Fax# School Verification (If applicable - 18 and older) Name of School: School address: Phone#: Fax# Child Care Provider (If applicable) Name of Child Care Provider: Child Care Providers address: Phone#: Fax# Child Support (all filed child support orders, regardless of whether payment is received and proof of payment) Cause# CIN# Unemployment Benefits (If applicable) Did you apply for unemployment benefits? Yes (Attach status letter) No (ust apply and provide proof) Start Date: End Date: Weekly Benefit Amount:

5 Housing Choice Voucher Program SCHOOL VERIFICATION Due back by / / Date: / / Client Name: Client #: To Student Name: Student SS #: The household member named above has applied for, or is recertifying eligibility for, housing assistance under a program of the U.S. Department of Housing and Urban Development (HUD). HUD requires us to verify all information that is used in determining the person s eligibility or level of benefits. Please make sure to include this completed form with your request for change along with a copy of the student class schedule. I,, consent to allow The Houston Housing Authority to request and obtain the income information from the sources listed on this form for the purpose of verifying my eligibility and level of benefits under HUD s assisted housing programs. - ATTENDANCE OFFICE OR ADISSIONS OFFICE, PLEASE COPLETE THE FOLLOWING: This student is attending: Full-time Part-time If attending College, University or Trade School: Number of hours per semester Signed: Position: Phone: Fax: Date: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government.

6 HHA APPLICANT/TENANT CERTIFICATION FOR CHILDCARE EXPENSES Client Name: Client #: I/We hereby certify that the following represent true and accurate statements regarding our household circumstances related to childcare: Child/children cared for are under 13 years of age. Reason for care (check one) Such care enables the following family member to work: Occupation: Employer, address & phone number: Hours worked: per week, month Such care enables a family member to attend vocational or academic courses: ember's name: Course: Institution name, address & phone #: Hours at school: Childcare costs are not paid to anyone living in our household; they are paid to: Name: Address & Phone # : I/We do not receive reimbursement for childcare costs from any agency or individual outside the household. I/We recognize that the above statements are subject to third-party verification. Signature

7 HHA CHILDCARE VERIFICATION (Individual/Babysitter provides Care) Dear Sir/adam: has applied for or is a participant in the Housing Choice Voucher program. Please fill in the blanks below and return this letter to us as soon as possible. All information is confidential and is only used to help determine the participant s housing subsidy. Name(s) and age(s) of child(ren) cared for: Name of Child Care Provider: Address: Phone # Contact Person: Childcare is provided on the following days for the hours indicated: onday: hours Tuesday: hours Wednesday: hours Thursday: hours Friday: hours Saturday: hours Sunday: hours Total hours per week: Cost of Care: $ Total hours per month:, per week month. $ received for care from family named above: $, week month. $ received for care from others (if any): $, week month. Name of individual, program, or other third-party source providing childcare funds for this family: Address: Estimated cost of care to the family for the upcoming 12 months: Signature Date TENANT/APPLICANT RELEASE I,, hereby authorize the release of the requested information. Signature Date

8 Authorization for the Release of Information/ Privacy Act Notice to the U.S. Department of Housing and Urban Development(HUD) and the Housing Agency/Authority (HA) PHA requesting release of information; (Cross out space if none) (Full address, name of contact person, and date) U.S. Department of Housing and Urban Development Office of Public and Indian Housing OB CONTROL NUBER: IHA Requesting Release of information of information:(cross out space if none) (full address, name of contact person, and date) Houston Housing Authority 2640 Fountain View Suite 100 Houston, TX Authority: Section 904 of the Stewart B. ckinney Homeless Assistance Amendments Act of 1988, as amended by Section 903 of the Housing and Community Development Act of 1992 and Section 3003 of the Omnibus Budget Reconciliation Act of This law is found at 42 U.S.C This law requires that you sign a consent form authorizing: (1) HUD and the Housing Agency/Authority (HA) to request verification of salary and wages from current or previous employers; (2) HUD and the HA to request wage and unemployment compensation claim information from the state agency responsible for keeping that information; (3) HUD to request certain tax return information from the U.S. Social Security Administration and the U.S. Internal Revenue Service. The law also requires independent verification of income information. Therefore, HUD or the HA may request information from financial institutions to verify your eligibility and level of benefits. Purpose: In signing this consent form, you are authorizing HUD and the above-named HA to request income information from the sources listed on the form. HUD and the HA need this information to verify your household s income, in order to ensure that you are eligible for assisted housing benefits and that these benefits are set at the correct level. HUD and the HA may participate in computer matching programs with these sources in order to verify your eligibility and level of benefits. Uses of Information to be Obtained: HUD is required to protect the income information it obtains in accordance with the Privacy Act of 1974, 5 U.S.C. 552a. HUD may disclose information (other than tax return information) for certain routine uses, such as to other government agencies for law enforcement purposes, to Federal agencies for employment suitability purposes and to HAs for the purpose of determining housing assistance. The HA is also required to protect the income information it obtains in accordance with any applicable State privacy law. HUD and HA employees may be subject to penalties for unauthorized disclosures or improper uses of the income information that is obtained based on the consent form. Private owners may not request or receive information authorized by this form. Who ust Sign the Consent Form: Each member of your household who is 18 years of age or older must sign the consent form. Additional signatures must be obtained from new adult members joining the household or whenever members of the household become 18 years of age. Persons who apply for or receive assistance under the following programs are required to sign this consent form: PHA-owned rental public housing Turnkey III Homeownership Opportunities utual Help Homeownership Opportunity Section 23 and 19(c) leased housing Section 23 Housing Assistance Payments HA-owned rental Indian housing Section 8 Rental Certificate Section 8 Rental Voucher Section 8 oderate Rehabilitation Failure to Sign Consent Form: Your failure to sign the consent form may result in the denial of eligibility or termination of assisted housing benefits, or both. Denial of eligibility or termination of benefits is subject to the HA s grievance procedures and Section 8 informal hearing procedures. Sources of Information To Be Obtained State Wage Information Collection Agencies. (This consent is limited to wages and unemployment compensation I have received during period(s) within the last 5 years when I have received assisted housing benefits.) U.S. Social Security Administration (HUD only) (This consent is limited to the wage and self employment information and payments of retirement income as referenced at Section 61 03(l)(7)(A) of the Internal Revenue Code.) U.S. Internal Revenue Service (HUD only) (This consent is limited to unearned income [i.e., interest and dividends].) Information may also be obtained directly from: (a) current and former employers concerning salary and wages and (b) financial institutions concerning unearned income (i.e., interest and dividends). I understand that income information obtained from these sources will be used to verify information that I provide in determining eligibility for assisted housing programs and the level of benefits. Therefore, this consent form only authorizes release directly from employers and financial institutions of information regarding any period(s) within the last 5 years when I have received assisted housing benefits.

9 Consent: I consent to allow HUD or the HA to request and obtain income information from the sources listed on this form for the purpose of verifying my eligibility and level of benefits under HUD s assisted housing programs. I understand that HAs that receive income information under this consent form cannot use it to deny, reduce or terminate assistance without first independently verifying what the amount was, whether I actually had access to the funds and when the funds were received. In addition, I must be given an opportunity to contest those determinations. This consent form expires 15 months after signed. Signatures: Head of Household Date Social Security Number (if any) of Head of Household Other Family ember over age 18 Date Spouse Date Other Family ember over age 18 Date Other Family ember over age 18 Date Other Family ember over age 18 Date Other Family ember over age 18 Date Other Family ember over age 18 Date Privacy Act Notice. Authority: The Department of Housing and Urban Development (HUD) is authorized to collect this information by the U.S. Housing Act of 1937 (42 U.S.C et. seq.), Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d), and by the Fair Housing Act (42 U.S.C ). The Housing and Community Development Act of 1987 (42 U.S.C. 3543) requires applicants and participants to submit the Social Security Number of each household member who is six years old or older. Purpose: Your income and other information are being collected by HUD to determine your eligibility, the appropriate bedroom size, and the amount your family will pay toward rent and utilities. Other Uses: HUD uses your family income and other information to assist in managing and monitoring HUD-assisted housing programs, to protect the Government s financial interest, and to verify the accuracy of the information you provide. This information may be released to appropriate Federal, State, and local agencies, when relevant, and to civil, criminal, or regulatory investigators and prosecutors. However, the information will not be otherwise disclosed or released outside of HUD, except as permitted or required by law. Penalty: You must provide all of the information requested by the HA, including all Social Security Numbers you, and all other household members age six years and older, have and use. Giving the Social Security Numbers of all household members six years of age and older is mandatory, and not providing the Social Security Numbers will affect your eligibility. Failure to provide any of the requested information may result in a delay or rejection of your eligibility approval. Penalties for isusing this Consent: HUD, the HA and any owner (or any employee of HUD, the HA or the owner) may be subject to penalties for unauthorized disclosu res or improper uses of information collected based on the consent form. Use of the information collected based on the form HUD 9886 is restricted to the purposes cited on the form HUD Any per son who knowingly or willfully requests, obtains or discloses any information under false pretenses concerning an appl icant or participant may be subject to a misdemeanor and fined not more than $5,000. Any applicant or participant affected by negligent disclosure of information may bring civil action for damages, and seek oth er relief, as may be appropriate, against the officer or employee of HUD, the HA or the owner responsible for the unauthorized disclosure or improper use. Original is retained by the requesting organization. ref. Handbooks , , & form HUD-9886 (7/94)

10 AUTHORIZATION FOR RELEASE OF INFORATION CONSENT I authorize and direct any federal, state or local agency, organization, business, or individual to release to the Houston Housing Authority any information or materials needed to complete and verify my application for housing assistance and/or to maintain my continued occupancy of housing furnished by or through the Housing Authority. I understand and agree that this authorization or the information obtained with its use may be given to and used by the Housing Authority in administering and enforcing program rules and policies. I also consent for HUD or the Housing Authority to release information from my participant file related to my rental history to credit bureaus, collections agencies and/or future landlords. This includes records on my payment history, and any violations of my lease or PHA policies. I authorize the Houston Housing Authority to release to any entity or person any information relating to me if the Houston Housing Authority determines that releasing such information might lead to additional assistance being provided to me. INFORATION COVERED I understand that, depending on program policies and requirements, previous or current information regarding my household or me may be requested; this includes but is not limited to: Identity and arital Status edical or Child Care Allowances Employment, Income, and Assets Residences and Rental Activity Income Credit and Criminal Activity I understand that this authorization cannot be used to obtain any information about me that is not pertinent to my eligibility and continued participation in a housing assistance program. GROUPS OR INDIVIDUALS THAT AY BE ASKED The groups or individuals that may be asked to release the above information (depending on program requirements) includes, but not limited to: Previous Landlords (including Veteran s Administration Retirement/Pensions Public Housing Agencies) Welfare Agencies Courts and Post Offices Law Enforcement Agencies Schools and Colleges Social Security Support and Alimony Providers Credit Bureaus and Providers Administration Utility Companies ortgage Companies Lending Institutions edical and Child Care Providers COPUTER ATCHING NOTICE AND CONSENT I understand and agree that the Housing Authority may conduct computer-matching programs to verify the information supplied for my application or re-examination. If a computer match is done, I understand that I have a right to notification of any adverse information found and a chance to disprove incorrect information. HUD or the Housing Authority may, in the course of its duties exchange such automated information with other federal, state, or local agencies, including but not limited to State Employment Security agencies; Department of Defense; Office of Personnel anagement; U.S. Postal Services; Social Security Agency; and State Welfare and food stamp agencies. Page 1 of 2

11 CONDITIONS I agree that a photocopy of this authorization may be used for the purposes stated above. The original of this authorization is on file with the PHA and will stay in effect for a year and three months from the date signed. I understand I have a right to review my file and correct any information that I can prove is incorrect. Signature(s) Printed Name Date Head of Household Spouse/Co-Head Adult ember NOTE: This general consent may not be used to request a copy of a tax return. If a copy of a tax return is needed, IRS Form 4506, Request for a copy of a tax form must be prepared and signed separately. Page 2 of 2

12 (An asset is something of value that can be converted to cash) HOUSEHOLD ASSETS SELF - CERTIFICATION 1. Does any member of your family have ACCESS to any of the following? Savings Account.. Yes No Certificate of Deposit. Yes No Checking Account Yes No oney arket Account. Yes No Explain any Yes answers below. Family ember Name Bank Name Account Number Balance Does any member of your family own or have access to any of the following? Stocks. Yes No Individual Retirement Account (IRA).. Yes No Bonds.. Yes No Inheritances. Yes No Real Estate (Property/Land). Yes No Life Insurance Policies. Yes No Trust Funds. Yes No 401K or 403B Accounts. Yes No Pensions. Yes No Any other type of Capital Investment. Yes No Explain any "Yes" answers below. Family ember Name Type of Asset Account Number Value 3. Is the value of any asset that you answered yes to above $5,000? Yes No IF YOU ANSWERED YES TO ANY QUESTION ABOVE ABOUT ASSETS AND THE VALUE IS OVER $5,000 YOU ARE REQUIRED TO PROVIDE THE OST RECENT ONTHLY OR QUARTERLY STATEENT FOR EACH ASSET. 1of 2

13 Certification of Information WARNING: TITLE 18, SECTION 1001 OF THE UNITED STATES CODE STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY AKING FALSE OR FRAUDULENT STATEENTS TO ANY DEPARTENT OR AGENCY OF THE UNITED STATES AND SHALL BE FINED NOT ORE THAN $10,000 OR IPRISONED FOR NOT ORE THAN FIVE YEARS OR BOTH. I hereby certify that all of the information I have provided on this reexamination form is true and complete. Signature of Head of Household Date Signature of Spouse or Co-head Date Current Phone Number Name & Phone Number of an Emergency Contact Address 2 of 2

14 Housing Choice Voucher Program REGULAR CONTRIBUTIONS & GIFTS (Print Name of Client) has stated that you assist him/her in support of their family. The following Contribution form provided with this document is to be filled out by the person who provides assistance to the client listed above in support of his/her family. The person completing this form must sign and print their name and list their relationship to the client listed above. You must complete this form listing dollar amount(s) next to the area you provide support. If you pay Child Support that has not been ordered by the court, indicate what means of support you provide. If you are supporting the above client until they are able to provide their own means of income, identify the means of support that best describes the support that you provide on the following documents. PLEASE AKE CERTAIN YOU READ AND UNDERSTAND THE ABOVE INFORATION BEFORE YOU COPLETE AND SIGN THE ATTACHED FOR. 1 of 2

15 Housing Choice Voucher Program Regular Contributions & Gifts Certification I,, certify that I contribute the following items to, (Name of person providing contribution) (Print name of Client) in support of their family. ITE AOUNT WEEKLY ONTHLY Cash: Rent: Utilities: Electric Gas Water/Sewer Phone Groceries: Personal Hygiene Products: Child Care: Automobile: Gas Oil Repairs Notes Insurance Bus Fare Transportation: Health: Life edical Dental Legal: Clothing: Laundry/Dry Cleaning: TOTAL: $ $ $ Signature of Individual Providing Contribution Relationship to Client Date Address Phone number WARNING * Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements or misrepresentation to any Department or Agency of the United States as to matters within its jurisdiction. 2 of 2

16 CRIINAL BACKGROUND CHECK RELEASE FOR Este formulario está disponible en español a petición. The Houston Housing Authority ( HHA ) requires all applicants or participants (Head of Household and listed household members) 18 and older to submit to a criminal background screening. The background screening may be conducted prior to admission, at any recertification, prior to moves, or at any time relating to any alleged criminal violation for the purposes of determining your initial or continuing eligibility. HHA will exercise all rights according to HUD guidelines to deny, terminate and/or evict any applicant or participant who fails the background screening according to HHA policies and procedures. Federal law also requires you to cooperate by supplying information regarding the criminal activity of any adult members of your household. False answers and/or failure to list all arrests, convictions or pending criminal charges are cause for disqualification, termination and/or eviction from HHA s programs. ***Warning: 18 U.S.C provides that any individual who, knowingly and willfully falsifies, conceals, or covers up a material fact, or; makes any materially false, fictitious, or fraudulent statement or representation; or makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or representation; or makes or uses any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry shall be fined no more than $10,000 or imprisoned for not more than five years, or both. Last Name: First Name: iddle Name: Date of Birth: / / SS# / / DL or ID# 1. Have you ever been evicted or terminated from Public Housing and/or a subsidized housing program for engaging in drug related or other criminal activity? ( ) YES ( ) NO 2. If you answered YES to Question No. 1, please describe each instance here: (Use additional pages if necessary) Housing Authority Reason for Termination and/or Eviction 3. Have you been arrested or convicted within the past 5 years, or do you have any pending criminal charges? ( ) YES ( ) NO 4. If you answered YES to Question No. 3, please list each arrest, conviction and/or pending criminal charges here: (Use additional pages if necessary) Date of Offense City/County/State Charges Penalty 5. Have you ever used any name other than your birth name or married name? ( ) YES ( ) NO 6. If you answered YES to Question No. 5, please list any other names you have ever used here: (Use additional pages if necessary) I certify that the above information and answers provided are true and correct. I also understand that if any of this information is found to be false or incomplete, my application, participation and/or lease may be terminated at any time. I authorize HHA to conduct a criminal background check to verify my statements on this form and my eligibility for HHA s programs. Applicant/Resident Signature Date (For Office use only) Client # Requested by Housing Specialist Rev

17 Housing Choice Voucher Program Declaration of U.S. Citizenship or Non Citizens with Eligible Immigration Status and Immigration Status Release of Evidence I,, certify, under penalty of perjury, that, to the best of my knowledge, I am lawfully in the United States because: (Check appropriate box) I am a citizen, naturalized or national of the United States: I am not a citizen or national of the United States nor do I have eligible immigration status. I have eligible immigration status as defined in the Immigration and Nationality Act (INA) or 1952 and have provided appropriate documents proving that status: Immigrant status [INA Sections 101(a) (15) or 101(a) (20)] Permanent residence [INA Section 249] Refugee, asylum or conditional entry status [INA Sections 207, 208, or 203] Parole status [INA Section 212(d) (5)] Threat of life or freedom under [INA Section 243(h)] Amnesty [INA Section 249A] I hereby grant my consent for Houston Housing Authority to release evidence of my eligible immigration status without responsibility for the further use or transmission of the evidence by the entity receiving it to: A. The Department of Housing and Urban Development (HUD) as required by HUD; B. The U.S. Citizenship and Immigration Services (USCIS) for purposes of verification of the Immigration status of the individual named on this form. This notice is required to inform you that it is possible that the evidence of eligible immigration status may be released by HUD. Evidence of eligible immigration status shall only be released to the USCIS for purposes of establishing eligibility for financial assistance and not for any other purpose. HUD is not responsible for the further use or transmission of the evidence or other information by the Houston Housing Authority as required by HUD and the USCIS for purposes of verification on the immigration status of the individual. Date Signature Signature for inor or Relationship For children under the age of 18, the release of evidence form must be signed by the responsible adult who will reside in the unit. WARNING: 18 USC 1001 provides that whoever knowingly and willfully makes or uses a document or writing containing any false, fictitious, or fraudulent statement or entry in any matter within the jurisdiction of any department or agency of the United States, shall be fined not more than $10,000 or imprisoned for not more than five years, or both.

18 Housing Choice Voucher Program Lead Base Paint Questionnaire FILL OUT AND RETURN Name: Client Status: Active Searching Housing Choice Voucher Client #: Date: 1. How many children in the household are under the age of 6? 2. Are there any children under the age of 6 in the household with an Environmental Intervention Blood Lead Level (Lead Poisoned Child)? 3. If YES to question #2, please GIVE THE NAE, BIRTHDATE AND GENDER of the child or children under the age of six (6) with an Environmental Intervention Blood Lead Level: Child s Name Date of Birth Gender (F = Female & = ale) Head of Household: Date: (Signature) THIS QUESTIONNAIRE DOES NOT GO TO THE AGENT/OWNER OR LANDLORD For Houston Housing Authority Employees to Complete ONLY: Occupancy Technician: Program Type:

19 TEXAS WORKSOURCE UNEPLOYENT BENEFITS SERVICES Customer Service Tele Center is available onday - Friday 7am 6pm to speak to a customer service representatives regarding question such as: -How to apply for unemployment benefits? -What is the status of my claim? -How can I retrieve my information online? -I am missing a form, how can I retrieve another copy of a document that was mailed to me? -I got laid off can I still apply for benefits? -When did my benefits end? -When can I expect to receive my first unemployment benefits check? How to apply for unemployment benefits online using the TWC website Go to TWC Website From the main page go to the Quick links section and clink on Unemployment Benefits Services On the next page choose one of the following Log in options: -Returning User -Sign Up for a TWC Internet User ID Direct Link -Enter user ID and password and click the Logon button

20 COUNITY RESOURCES The following agencies are great resources that offer unique and valuable services that everyone should know about. Only the agencies themselves can tell you whether or not you qualify and the programs they offer can change anytime. United Way of Greater Houston HELP Windsor Village Social Services Houston Area Community Services Asian American Family Services Cypress Assistance inistries Southeast Area inistry Brentwood Project WAITT Harris County Social Services Gulf Coast Community Svcs Central Salvation Army Houston Area West Houston Assistance inistries Humble Area Assistance inistries New Hope Counseling Centers City of Houston Office of Veterans Affairs Dispute Resolution Center Link Up America/Lifeline U Houston Area Women s Center TWC- Child Care Assistance S Lite UP Texas U SER Jobs for Progress of the Texas Gulf Coast E, J Career and Recovery Resources, Inc E, J Harris County Rides T ETRO T SNAP- Food Benefits F Texas Attorney General Child Support Division S Harris County Public Health WIC program F Sign Language Accessible Interpreters Operation Jobs E, J GCCS-JD Walker ulti-service Center E, J, Way to Work Car Loan Program T Fair Haven Food Pantry F Houston Food Bank Hotline F Social Security Administration oney anagement International D Key : J- Jobs U-Utilities H- Health F- Food D-Debt and Budget Counseling E- Education S- Shelter T-Transportation -ultiple Resources S-Support Services

21 Interim Change of Family Composition FAQ Q1. Can I add my child or relative to the household who is over 18 years of age? A. You can submit the request to add with all required documents and wait for the decision. However HHA is not required to add on an adult. Q2. I would like to add on my grandchild to my household who is under the age of 18? What documents will I need? A. You must provide a court award showing you have legal custody of the child along with copies of the birth certificate and social security card. We will not accept a notarized letter or letter from the parent of the child. Q3. I recently got engaged and would like to add my spouse to my household when we get married? Is this allowed and what documents will I needed? A. You can submit a request to add your spouse to your household and must report that change within 10 days. Before allowing anyone to move into your unit other than birth, legal adoption or court awarded custody; they must be approved by the Houston Housing Authority and your landlord. Failure to receive approval from HHA in advance could result in termination of assistance Q4. I would like to remove a child who is under age of 17 from the household. What documents should I submit? A. If your child has income such as Social Security, Social Security Disability, or Child support. You must submit the required documents showing the new beneficiary, a written letter and proof of address for the person the child resides with. B To remove a family member that is under the age of 18 with no income you must submit the Change of Family Composition packet. There are no other required documents needed. Q5. How will I know that my request for a change in family composition is complete? A. If you are approved for a Change in Family Composition an approval letter will be mailed to you and to the landlord. If your request has been denied a denial letter will be mailed to you and your landlord within 30 days.