Annual Gross Income
Annual Income
- The anticipated total income of an eligible family from all sources for the 12 month period following the date of determination of income, computed in accordance with regulations
Adjusted Income
Adjusted Income
- Annual income, less allowable HUD deductions and allowances (including the Dependent Allowance of $480 for each family member who is a minor, family members who are 18 and older who are full time students or who are disabled as well as the Elderly/Disabled Allowance of $400 per family for families whose head of household or spouse is 62 or over or disabled, Allowable Medial Expenses for all family members of an eligible elderly/disabled family, Allowable Child Care Expenses and Allowable Disability Assistance Expenses)
Owner's Requested Rent
Indicate Zip Code
Select Below
Not Listed
44017
44022
44040
44070
44101
44102
44103
44104
44105
44106
44107
44108
44109
44110
44111
44112
44113
44114
44115
44116
44117
44118
44119
44120
44121
44122
44123
44124
44125
44126
44127
44128
44129
44130
44131
44132
44133
44134
44135
44136
44137
44138
44139
44140
44141
44142
44143
44144
44145
44146
44147
44149
44181
Indicate Voucher Size - RFTA bottom of Page 1
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0
1
2
3
4
5
6
7
8
Indicate Unit's Bedroom Size
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0
1
2
3
4
5
6
7
8
Will the applicant pay for Electricity?
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Yes
No
Will the applicant pay for Gas or Electric energy source costs?
(heating, cooking, water heating)
Select Below
Yes
No
Indicate Unit's Type
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Single-family dwelling
Townhouse, Duplex/Triplex, Row House
Multi-unit apartment
Manufactured home
Indicate Heating Energy Source
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None
Natural Gas
Electric (Resistance Heating)
Electric (Heat Pump)
Indicate Cooking Energy Source
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None
Natural Gas
Electric (Resistance Heating)
Indicate Water Heating Energy Source
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None
Natural Gas
Electric (Resistance Heating)
Will the applicant pay for water/sewer?
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Yes
No
Will the applicant pay for trash collection?
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Yes
No
Which appliances (if any) will the applicant provide?
Range
Refrigerator