Instructions for
Completing Application

PART 1

Please provide all information for all family members. Please provide Social Security Numbers for all children, if available.

PART 2

Please complete this information using your current address.

PART 3

When completing wage and benefit information, please indicate if the figures you provide are yearly or monthly income.

Section 8 Housing Assistance Payment Program for Housing

…is a way to help you with rental costs.
It may help you afford a better place to live.
The program pays your landlord part of your monthly rent.

YOU MAY QUALIFY IF:

1. Your household includes one of the following:

A single person 62 years of age or older, a single person who is disabled or handicapped, a singleperson who is pregnant, or a single person
Persons who are handicapped, disabled or 62 years of age or older who live with other persons alsohandicapped, disabled or over 62, or who live with someone who takes care of them
Persons displaced by governmental action or natural disaster
Yourself and one or more family members

AND...

2. Your total household income is not over program limits

PART I

Family Member NumberFirst Name and Middle Initial of Household MemberLast Name of Household MemberSocial Security NumberRelationship
to YouSexDate of Birth (Month, Day, Year)HeadSpouse123

Ethnicity

Number of Family Members

Minority

Household Status (Check as many as apply)

PART II

Mailing Address

City

County

State

Zip Code

Telephone Number

Do you live within city limits?

PART III

Family Member NumberWages,
Salaries, Etc.Social Security, Pensions, Etc.Public Assistance (incl. SSI)Income from AssetsOtherFamily AssetsHeadSpouse123

PRIVACY ACT STATEMENT – The information on this form is being collected by the Department of HUD to determine an applicant’s eligibility. It will be used to provide the basis for managing the programs covered by this form, for protection the Government’s financial interest, and for verifying the accuracy of the information furnished. It may be released to appropriate Federal, State and Local agencies when relevant, to civil, criminal or regulatory investigators or prosecutors. It is not mandatory to provide social security number. However, failure to provide any information may result in a delay or rejection of your eligibility approval. The Department is authorized to ask for this information by the U.S. Housing Act of 1937, as amended, 42 U.S.C., 1437 et seq., the Housing and Community Development Amendments of 1987, P.L. 97-35, 85 Stat., 348, 408.TENANT STATEMENT – I/We certify that the statements in Parts I, II and III above are true and complete to the best of my/our knowledge and belief. I/We understand that false statements or information are punishable under Federal Law.

RELEASE NOTE: Should you relocate prior to being contacted by our Field Agent, please be sure to notify the Department of Commerce office in writing with your new address. If our Field Agent cannot contact you, your number will be passed by, and you willbe required to reapply.

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Instructions for
Completing Application

The Montana Department of Commerce

Section 8 Housing Assistance Payment Program for Housing

Application for Section 8
Housing Assistance
Payments Program

PART I

PART II

PART III

Hours

Instructions forCompleting Application

The Montana Department of Commerce

Section 8 Housing Assistance Payment Program for Housing

Application for Section 8 Housing AssistancePayments Program

PART I

PART II

PART III

Hours

Instructions for
Completing Application

Application for Section 8
Housing Assistance
Payments Program