Lease Addition Request Form

To add a new member to your household’s lease, please complete this form in full and submit it along with any required documentation to the management office. Approval is subject to program regulations and verification process.

Head of Household Information

To start, we'll need the information of your current Head of Household

Name

of Head of Household

Address

of Head of Household

Phone

of Head of Household

(###)

###

####

Proposed New Household Member

Next, we'll need the information of the new person who will be joining the household

Name

of incoming person

Relationship to Head of Household

Current Address

of incoming person

Date of Birth

of incoming person

Current Immigration Status

of incoming person

Reason for Addition

Choose one from the list and provide supporting documents

Birth/Adoption of Child/Legal Custody (provide birth certificate or custody documents and social security card)

Marriage (provide marriage certificate)

Live-In Aide (must complete Certification of Need)

Other Justification (please explain on the line below – must be approved by Compliance Department)

Acknowledgement and Certification

By clicking the SUBMIT button below, I certify that the information provided on this form is true and complete to the best of my knowledge. I understand that providing false or incomplete information may result in denial of the request. I agree to comply with all HUD and lease requirements.

Lease Addition Request Form

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