Landlord Information

List the name, address, and telephone number of your landlords for the past three years below.

Name:

Address:

Telephone:

Name:

Address:

Telephone:

Name:

Address:

Telephone:

 

Have you ever lived in public housing or participated in the section 8 existing program? Yes No

If Yes, When Where

Under What Name

Who was Head of Household

 

Please Print Page and Bring It To:             100 Crumrine Tower, Franklin Street,
                                                                 Washington, Pennsylvania. 15301-6995



Washington County Housing Authority
©Copyright 2002-2003, Melissa McClure

Last revised: May 17, 2003 .