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APPLICATION for PUBLIC/ PHA-OWNED HOUSING

This is not a Section 8 application and cannot be used for the Housing Voucher program.

Instructions: Please read Carefully. Incomplete applications will not be processed.

This application is valid for all public housing properties operated by the Poinsett County Housing Authority hereinafter referred to as "PHA".


To be qualified for admission to public housing an applicant must:

  • Be a family as defined in PHA’s Admission and Continued Occupancy policy;
  • Document citizenship or eligible immigration status or pay a higher rent;
  • Have an Annual Income at the time of admission that does not exceed the income limits established by HUD that are posted in PHA office.
  • Provide documentation of Social Security numbers for all family members
  • Meet or exceed the Applicant Selection Criteria;
  • Pay any money owed to PHA or any other housing authority;
  • Not have had a lease terminated by a PHA in the past 12 months;
  • Be able and willing to comply with the PHA lease;
  • Not have any family members engaged in any criminal activity that threatens the life, health, safety, or right to peaceful enjoyment of the premises by other residents, and not have any family members engaged in any drug-related criminal activity;
  • Not have any family members subject to a lifetime sex offender registration in any state.

The following items must be presented at the time of application:

  • Picture I.D. For all persons over the age of 18
  • Proof of Income
  • Proof of SNAP benefits
  • Social Security card for all members of the household
  • Rental References: Names, addresses and phone numbers for Landlord references.
  • Office State Birth certificate for all members of the Household
  • Marriage License, Divorce Decree, or Legal form of Separation
  • Proof of assets and (2) month Bank Statements
  • Proof of Child Support (even if you do not receive it)

Complete applications will be entered on the waiting list in the order received. The waiting list will then be processed in order according to unit type and size (and admission preferences if applicable). Each applicant who meets the above qualifications will receive one unit of the size and type needed. If the applicant accepts the offer, the applicant will be offered a lease. If the applicant refuses the offer without good cause, the application will be withdrawn from the waiting list and the applicant will not be permitted to reapply for 12 months will conduct a criminal record check on all adult applicants or those for whom adult records are available.


Applicants with disabilities will be given assistance, if requested, with the completion of the application at PHA’s office at the address above.

Download Here.

The Housing Authority is an Equal Housing Provider

APPLICATION for PUBLIC/ PHA-OWNED HOUSING

For Statistical Purposes Only:

Family Information:

List all persons who will live in the unit, including foster children, live-in aides (if needed for the care of a family member). No one except those listed on this form may live in the unit.

Family Information: #member1

Family Information: #member2

Family Information: #member3

Family Income Information

Please list the source and amount of all income expected for the coming 12 months for all family members, including but not limited to all earnings and benefits received from working, TANF, VA, Social Security, SSI, SSID, Unemployment, Worker’s Compensation, pension, Child Support, etc.

Example: Wages, $150/week, SSI, $421/month

Family Income Information: #member1

Family Income Information: #member2

Screening

Qualifying for Deductions in Calculating Rent

If yes, please answer the following questions. (If no, please skip down to question upto, "Do you have child care expenses for children under age 13 so an adult in the family can work, go to school or attend job training?")

PHA will be contacting all former landlords for the period three years from the date of application

I/we certify that the statements on this application are true to the best of my/our knowledge and belief and understand that they will be verified. I/we authorize the release of information to the Housing Authority by my/our employer(s), the Arkansas Health and Human Services Commission, the Social Security Administration, and/or other business or government agencies. I/we understand that any false statement made on this application will cause me/us to be disqualified for admission.

Warning: 18 U.S.C. 1001 provides, among other things that whoever knowingly and willfully makes or uses a document or writing containing false, fictitious or fraudulent statement or entry in any matter within the jurisdiction of a department or an agency of the United States shall be fined not more than $10,000 or shall be imprisoned for not more than five years or both.

Background Check Authorization

I, hereby authorize Poinsett County Housing Authority and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for housing purposes. I understand that the scope of this report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

Office use only. Do not write below this line

Applicant's Present Address:

Accepted formats: PDF, Word (doc, docx), JPEG, JPG, PNG. Max 10 MB.