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LOSS OF INCOME TENANT SELF-VERIFICATION

LOSS OF INCOME TENANT SELF-VERIFICATION

  • Date Format: MM slash DD slash YYYY
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  • By signing below you are certifying that the information reported is true and that you understand that all increases of income must be reported to MHA. Not reporting an increase in income within 30 days of the increase or providing false information will result in the future termination of my housing assistance. Reporting of increases of income can be done via the drop box at 100 S. Arch St. or via fax 340-4708 or email (see caseworker list posted on door).

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