Decatur Housing Authority

1-800-4236

 

DHA is currently accepting applications for the following Public Housing sites which are exclusively for Elderly or Disabled individuals needing  0/1 bedroom.   

 

 


If you are eligible to be on the Elderly/Disabled waiting list (50 or older or disabled), please place a check mark next to the development or developments where you are interested in living. Please note that if you have a preference for only one development, you will not be contacted until there is a unit available in that development:

  Concord Highrise (333 E Center St)

  Lexington Highrise (1221 N Van Dyke St)

  Hartford Highrise (1096 W Decatur St)

  Garden Apartments (Poole St)

  Garden Apartments (Cantrell St)


  All Developments (choose this option is if you have no development preference)


IMPORTANT!!! PLEASE READ! LIST YOURSELF FIRST!! List each person who will live with you, using correct legal names. Incomplete applications will not be accepted. Please complete all sections of the application.


Last Name First Name MI Relation To You SEX Social Security Number Birth Date Race Are you Hispanic
or Latino?		 Disabled?

HEAD***

 Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No
Yes  No Yes  No

***Must be at least 18 years old or a court-ordered emancipated minor.


We only contact by mail. Where do you want your mail sent?

Street:

City, State, Zip:



Where are you residing (living)? (If different from where you mail is sent)

Street:

City, State, Zip:



Applicant's phone number or message phone:



Marital status:



If you listed dependent children above, are they in your custody?

Yes  No

Are you pregnant?

Yes  No

Do you currently reside and/or work in Macon County?

Yes  No

Does anyone in your household require specific accommodations?

Yes  No

If yes, please tell us what you need.



Is any adult on this application currently enrolled in an educational/training program?

Yes  No

If yes, name of person is:



List ALL income earned or received by everyone who WILL BE living in your household:

Household member Income From: How Much? How Often?


Are you and all other persons listed on the application citizens of the United States or legal immigrants?

Yes  No

If not, who is not:



Do you owe Decatur Housing Authority or any subsidized housing program money?

Yes  No

If yes, did you receive an Earned Income Disallowance?

Yes  No

Have you or any member of your household been arrested or convicted of any crime besides traffic violations?

Yes  No

If so --

Name Crime: Where? When?


Are you or any member of your household on probation or parole?

Yes  No

If so --

Name Crime: Where? When?


Are you or anyone in your household required to register on any sex offender list?

Yes  No

If yes, in which state and please explain:

Please take the time to tell us how you heard about Decatur Housing Authority.

  • Television Ad
  • Newspaper
  • Booklet or Pamphlet
  • Family or friend
  • Telephone book
  • Internet

Others:




I certify that the information given to the Authority is accurate and complete to the best of my knowledge and belief. I/we understand that false statements and/or information are punishable under Federal Law. I/we also understand that false statements and/or information are grounds for termination of housing assistance and termination of tenancy



Enter Validation Code: