Wayne Housing Commission 4001 S. Wayne Rd Wayne, MI Phone: (734) Fax: (734)

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1 Wayne Housing Commission 4001 S. Wayne Rd Wayne, MI Phone: (734) Fax: (734) The Wayne Housing Commission offers housing at various locations within the city. At this time, we do not offer the Section 8 Voucher Program. Rental charges are based on 10% of the tenant s gross yearly income, or 30% of their net income, whichever is greatest, OR a flat rent fee can be assessed if the tenant prefers. The Public Housing units offered include: 36 - one bedroom units are designated for seniors only (62 or older) 18 - one bedroom family units 10 - two bedroom family duplexes 10 - three bedroom family homes 2 - four bedroom family homes Any applicant may qualify for housing as long as the income level requirement establishing low income status and all other Wayne Housing Commission requirements are met. The Wayne Housing Commission hereby conforms to the Fair Housing Amendment Act of 1988 and has available barrier-free units for those applicants requiring accommodations. The wait at this time is at least five years, depending of the size of the unit required and the turnover time for each unit. When a unit is available, the next applicant on the waiting list will be contacted by first class mail at the last address on file for that applicant. Letters are sent once a year to applicants to update their contact information, so it is important to supply the Wayne Housing Commission with any change of address in writing. Applications are available by visiting the Wayne Housing Commission office at 4001 S Wayne Rd, Wayne, MI or on the City of Wayne website ( If you or anyone in your family is a person with disabilities, and you require a specific accommodation in order to fully utilize our programs and services, please contact the Wayne Housing Commission. Bridget Piasecki, PHM Executive Director 1

2 For office use only Unit Size: Household Type: WAYNE HOUSING COMMISSION 4001 S WAYNE ROAD WAYNE, MI (734) PLEASE NOTE: An application that is not completely filled out will not be processed. A P.O. Box will not be accepted for an address. A physical address is required. NAME ADDRESS APT # CITY STATE ZIP CODE HOME PHONE # WORK PHONE # Please list Head of Household first and then all persons who will live in the household. Relation First Name Last Name Social Security Number To Head of House Sex Date of Birth City & State of Birth Do you or anyone in your household use illegal drugs? Yes No Have your or any household member been involved in drug trafficking? Yes No Have you, or any member of your household, ever been arrested, charged, cited or 2

3 convicted of a sex crime, drug crime or any other felony. Yes No Have you ever lived in federally assisted housing? Yes No If yes, where and when: Have you ever been evicted from federally assisted housing? Yes No THIS INFORMATION IS FOR STATISTICAL PURPOSES ONLY White American Indian/Native Alaskan Hispanic Black Asian/Pacific Islander Non-Hispanic Is the head of household or spouse 62 years or older? Yes No Does anyone in your household require a barrier free unit? Yes No Is anyone in your family unable to use stairs? Yes No INCOME: Please indicate any income, for yourself, and each person who will live in the household. Include: Wages, overtime, tips, bonus or commissions before taxes, Social Security, Supplemental Security Income from Family Independence Agency, V.A. Benefits, Retirement Benefits, Unemployment Compensation, Worker s Compensation, Child Support or Alimony. Name Source of Income Amount per Month ASSETS: Please indicate assets held by all household members 18 years or older. Name Type of Asset Name of Bank Account # Amount How much is your monthly rent? How much is your monthly gas bill? $ $ 3

4 How much is your monthly electric bill? How much is your monthly water bill? $ $ All changes in information regarding this application must be reported in writing to the Wayne Housing Commission. If you have any questions please feel free to contact the Wayne Housing Commission at (734) I certify that the above information is correct and complete to the best of my knowledge and inquiries may be made to verify the statements made herein. Any intentional or willful misrepresentation of the facts included on this application may result in denial of housing. I understand and give full permission to the Wayne Housing Commission to check my background, including but not limited to credit check, reference checks, rental history, utility payment history, and criminal background check. I understand that this is only an application and does not guarantee that I will be housed with the Wayne Housing Commission. You MUST notify us, IN WRITING, immediately if any of the following events occur. Changes will not be accepted over the phone: You move to a new address, You get a new telephone number, Your household size increases or decreases, If you or anyone in your family is a person with disabilities, and you require a specific accommodation in order to fully utilize our programs and services, please contact the Wayne Housing Commission office. Signature of Head of Household Date REQUEST FOR REASONABLE ACCOMODATION 4

5 Reasonable accommodations do not confer special treatment or advantage for the person requesting the accommodation. Rather they make the program fully accessible in a way that would be otherwise not possible for persons with a disability. I,, do hereby request Wayne Housing Commission to grant me a reasonable accommodation. Accommodation requested: (Please provide a description of accommodation being requested) Are you disabled? (please circle) Y N How is your request related to the disability? Signature: Date: TO BE COMPLETED BY THE WAYNE HOUSING COMMISSION Accommodation is: approved or disapproved If disapproved, reason why: Bridget Piasecki, Executive Director Date c: Resident File Michigan Housing Commissions 5

6 PH - Public Housing S8 - Section 8 Both - S8 & PH (517)373- S8 - Michigan State Housing Development Authority 735 E. Michigan Lansing MI Address Zip Code Phone Commission Albion Housing Commission 1300 Cooper St (517) Box 630 Albion PH Algonac Housing Commission Allen Park Housing Commission Alma Housing Commission Alpena Housing Commission Ann Arbor Housing Commission Baldwin Housing Commission Bangor Housing Commission Baraga Housing Commission Bath Twp Housing Commission Battle Creek Housing Commission 1205 St. Clair River Dr. Algonac PH Champaign Allen Park PH 400 E. Warwick Alma Both 2340 S Fourth Ave Alpena PH 727 Miller Ave Ofc. Ann Arbor Both 105 Fournier Dr. PO Box 337 Baldwin Both 820 Second St Bangor PH 416 Michigan Ave Baraga Both Webster Rd Bath Both 250 Champion St (810) (313) (989) (989) (734) (231) (269) (906) (517) (269) Battle Creek Both ext. 105 Bay City Housing Commission 1200 N. Madison Bay City PH (989)

7 Bay County Housing Department 798 N. Pine Essexville PH (989) Bedford Twp. Housing Commission 8745 Lewis Ave Temperance PH (734) Belding Housing Commission 41 Belhaven Belding PH (616) Benton Harbor Housing Commission 721 Nate Wells Sr Dr Benton Harbor Both (269) Benton Twp Housing Commission 1216 Blossom Ln Benton Harbor Both (269) Bessemer Housing Commission 709 West Iron St Bessemer PH (906) Big Rapids Housing Commission 9 Parkview Village Big Rapids PH (231) Boyne City Housing Commission 829 S. Park St Boyne City Both (231) Bronson Housing Commission 318 S. Ruggles PO Box 33 Bronson PH (517) Cadillac Housing Commission 111 S Simons St Cadillac Both (231) Calumet Housing Commission 1 Park Ave Calumet PH (906) Caseville Housing Commission 6905 N. Caseville Rd Caseville PH (989) Charlevoix Housing Commission 210 W Garfield Ave (231) Charlevoix PH Cheboygan Housing Commission 659 Cuyler Cheboygan Both (231)

8 Clinton Twp Housing Commission Village Rd Clinton Twp Both (586) Coldwater Housing Commission 60 S Clay St Coldwater PH (517) Covert Housing Commission E Lake St Covert PH (269) Dearborn Housing Commission Michigan Ave Floor 2 Dearborn Both (313) Dearborn Heights Housing Commission Richardson Dearborn Heights S8 (734) Detroit Housing Commission 1301 E. Jefferson Ave. Detroit Both (313) Dowagiac Housing Commission 100 Chestnut St Dowagiac Both (269) Dundee Housing Commission 501 Rawson St Dundee PH (734) East Jordan Housing Commission 451 Water St East Jordan PH (231) East Tawas Housing Commission 304 W Bay St East Tawas PH (517) Eastpointe Housing Commission E. 9 Mile Rd Eastpointe Both (586) Eaton County Non-Profit 319 S Cochran Ave Charlotte S8 (517) Ecorse Housing Commission 266 Hyacinth Ave (313) Ecorse PH Elk Rapids Housing Commission 701 Chippewa St Elk Rapids PH (231)

9 Escanaba Housing Commission Evart Housing Commission Ferndale Housing Commission Flint Housing Commission Gladstone Housing Commission Gladwin City Housing Commission Grand Rapids Housing Commission Grayling Housing Commission Greenville Housing Commission Hamtramck Housing Commission Hancock Housing Commission Hermansville Housing Commission Highland Park Housing Commission Hillsdale Housing Commission Houghton Housing Commission 110 S 5th St Escanaba PH 601 W 1st St Evart Both 415 Withington Ferndale Both 3820 Richfield Rd Flint Both 217 Dakota Ave Gladstone PH 215 S Antler St Gladwin PH 1420 Fuller Ave SE Grand Rapids Both 308 Lawndale St Grayling Both 308 E Oak St Greenville Both 2620 Holbrook St Hamtramck PH 1401 Quincy St Hancock Both W W. Third Hermansville PH John R Highland Park PH 45 N West St Hillsdale PH 401 E Montezuma Ave (906) (231) (248) (810) (906) (989) (616) (989) (616) (313) (906) (906) (313) (517) (906)

10 Ingham County Housing Commission Inkster Housing Commission Ionia Housing Commission Iron County Housing Commission Iron Mountain Housing Commission Iron River Housing Commission Ironwood Housing Commission Ishpeming Housing Commission Jackson Housing Commission Kent County Housing Commission Kingsford Housing Commission Lake Linden Housing Commission L'Anse Housing Commission Houghton PH 3882 Dobie Rd Okemos Both 4500 Inkster Rd Inkster Both 667 N. Union St Ionia Both 210 N. 3rd St Crystal Falls Both 401 E D St Iron Mountain PH 236 N 3rd Ave Iron River PH 515 E. Vaughn St Ironwood PH 111 Bluff St Ishpeming PH 301 Steward Ave Jackson Both 82 Ionia Ave, NW Suite 390-3rd Floor Grand Rapids S Woodward Ave Kingsford PH 210 Calumet St Lake Linden PH 110 6th St L Anse PH (517) (313) (616) (906) (906) (906) (906) (906) (517) (616) (906) (906) (906) Lansing Housing Commission 310 Seymour Ave Lansing Both (517)

11 Lapeer Housing Commission Laurium Housing Commission Lincoln Park Housing Commission Livonia Housing Commission Luce County Housing Commission Luna Pier Housing Commission Mackinac County Housing Commission Madison Heights Housing Commission Manistee Housing Commission Manistique Housing Commission Marquette Housing Commission Marysville Housing Commission Melvindale Housing Commission 544 N. Saginaw St Lapeer Both 125 Lake Linden Ave Laurium PH 1356 Electric Ave Lincoln Park Both Purlingbrook Livonia Both 550 West Victory Newberry S Ellen St Luna Pier PH N9174 Kozy St 50 Curtis PH 300 W. Thirteen Mile Rd Madison Heights S th Ave Manistee PH 400 E Lakeshore Dr Manistique Both 316 Pine St Marquette` Both 1100 New York Ave. Marysville PH 3501 Oakwood Blvd. Melvindale Both (810) (906) (248) (248) (906) (734) (906) (248) (231) (906) (906) (810) (313) Menominee Housing Commission th Ave Menominee Both (906)

12 Middleville Housing Commission Monroe Housing Commission Montcalm County Housing Commission Mt. Clemens Housing Commission Mount Pleasant Housing Commission Munising Housing Commission Muskegon Housing Commission Negaunee Housing Commission New Haven Housing Commission Niles Housing Commission Ontonagon Housing Commission Paw Paw Housing Commission Plymouth Housing Commission Pontiac Housing Commission Port Huron Housing Commission 500 Lincoln St Middleville PH 20 N Roessler St Monroe PH 120 Mulberry Howard City Both 50 Church St. Mt. Clemens PH 1 W Mosher St Mount Pleasant Both 200 City Park Dr Munising Both 1080 E Hovey Ave Muskegon Heights Both 98 Croix St Negaunee PH John Rivers Dr. New Haven PH 251 Cass St Niles PH 100 Cane Ct Ontonagon PH 205 Miller Ct Paw Paw PH 1160 Sheridan Plymouth Both 132 Franklin Blvd Pontiac Both 905 Seventh St. Port Huron Both (269) (734) (231) (586) (989) (906) (231) (906) (586) (269) (906) (269) (734) (248) (810)

13 Potterville Housing Commission 210 E Main St Potterville Both (517) Rapid River Housing Commission N Main St Rapid River PH (906) Reed City Housing Commission 802 S Mill St Reed City Both (231) Redford Housing Commission Hemingway Redford (313) River Rouge Housing Commission 180 Visger PO Box River Rouge Both (313) Rockford Housing Commission 59 S Main St Rockford Both (616) Rockwood Housing Commission Fort St. Rockwood PH (734) Rogers City Housing Commission 643 W Erie St Rogers City PH (989) Romulus Housing Commission Beverly Rd Romulus PH (734) Roseville Housing Commission Eastland St Roseville Both (586) Royal Oak Housing Commission 211 Williams Royal Oak S8 (248) Royal Oak Twp Housing Commission 8901 Cloverdale Ferndale PH (248) Saginaw Housing Commission 1803 Norman St Saginaw Both (989) Saint Joseph Housing Commission 601 Port St St Joseph PH (269)

14 Saint Louis Housing Commission Saranac Housing Commission Sault Ste Marie Housing Commission Schoolcraft County Housing Commission South Haven Housing Commission South Lyon Housing Commission Southfield Housing Commission Stambaugh Housing Commission St. Clair Housing Commission St. Clair Shores Housing Commission Sterling Heights Housing Commission Sturgis Housing Commission Taylor Housing Commission 308 S Delaware St Saint Louis Both 203 Parsonage St Saranac PH 608 Pine St Sault Ste Marie Both 900 Steuben St Manistique Both 220 Broadway St South Haven PH 432 Washington St South Lyon PH Evergreen Southfield S8 208 Jefferson Ave Iron River PH 400 S. Third St. Clair Both 1000 Blossom Heath Blvd. St. Clair Shores Both Utica PO Box 8009 Sterling Heights Both 128 S. Nottawa St Sturgis PH S. Plaza Dr Taylor Both (989) (616) (906) (906) (269) (810) (248) (906) (810) (586) (586) (269) (734) Traverse City Housing Commission E Carter Center Traverse City Both (231)

15 Wakefield Housing Commission Wayne Housing Commission Westland Housing Commission Wyoming Housing Commission Ypsilanti Housing Commission 200 Pierce St Wakefield PH 4001 S. Wayne Rd Wayne PH Dorsey Westland S th St SW Wyoming Both 601 Armstrong Dr Ypsilanti Both (906) (734) (734) (616) (734)