Poinsett County DHS
406 North Illinois
Harrisburg, AR, 72432

We are required to verify the income of all applicants and participants in the federally-assisted housing programs operated by the Housing Authority. We ask for your cooperation in supplying the information listed below:

I do hereby authorize the Department of Human Services to furnish the Housing Authority with the information requested above. I also grant the PCHA permission to furnish the Department of Human Services with information regarding my file.



If you are disabled or have difficulty understanding English, please request our assistance and we will ensure that you are provided with meaningful access based on your individual needs.

Si usted es desactivar o tiene dificultad para entender Ingles, por favor solicite neustra ayuda y nos aseguramos de que se le proporciona un acceso significativo basado en sus necesidades individuales.

Haddii aad tahay wuxuu curyaamin ama ay ku adag tahay fahamka Ingiriisi, fadlan codsato gargaarka oo aan loo hubiyo in aad waxaa la siiya helaan macno leh oo ku salaysan baahiyahaaga shaqsi.

PLEASE RETURN TO: Poinsett County Housing Authority, 1104 Elm Street, Marked Tree, AR 72365 OR
FAX TO: (870) 358-4537