Policies | Links & Resources | Procurement | Online Forms | Grants | Human Resources Decatur Housing Authority 1-800-4236 Family Public Housing Pre Application Important! Please Read. We use this application form to determine if you are eligible for Housing Assistance and to place you on a waiting list. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. Decatur Housing Authority ulitizies a local preference. How bedroom size is determined: couples and partners receive one bedroom; other adults in household besides head of household receive a bedroom; two children of the same gender under the age of 18 are placed in one bedroom. If you have questions or need help completing this form, please contact our Applications Department. This is for Public Housing in Decatur ILLINOIS. This is NOT for Section 8 The 5 bedroom waiting list is open. The 1, 2, 3 and 4 Bedroom waiting lists are closed. 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*** M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander Yes No Yes No M F White Black/African American American Indian/Alaska Native Asian Native Hawaiian/Other Pacific Islander 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 your mail is sent) Street: City, State, Zip: Applicant's phone number or message phone: Marital status: Married Separated Divorced Never Married 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 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 Home | Board | Commissioners | Calendar | Public Housing | Family Housing Pre-Application | Elderly/Disabled Housing Pre-Application | Gallery | Section 8 | Owners | Contractors/Construction | Construction | News & Updates | Contact Us | Policies | Links & Resources | Procurement | Online Forms | Grants | Human Resources © 2010 Decatur Housing Authority. All Rights Reserved WEB DESIGN COMPANY DECATUR IL