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MUSKOGEE HOUSING AUTHORITY EFFECTIVE JANUARY 2007 BEFORE AN APPLICATION CAN BE ACCEPTED THERE
MUST
SECTION 8 PREFERENCE GUIDE LINES
Preference points are awarded to individuals whom can provide current proof of living and/or working in the city of Muskogee. Only one of the items listed needs to be brought in to qualify for the preference point. The following are accepted as proof:
Housing Authority of the City of Muskogee
ATTN: Section 8
Pre-Application The Muskogee Housing Authority provides reasonable accommodations on request. If you require a reasonable accommodation, please notify this office in writing of the reason for and type of accommodations being requested.
Social Security Number ____________________________Last Name _____________________________ First Name________________________________________ Middle Initial______ Other Name(s) Used:_______________________________________________________________________ Phone Number (home) (_____) - _____ - ______ (work) (_____) - _____ - ______ (message) (_____)-_____-______ Present Address___________________________________________________________________________ City, State, Zip Code_______________________________________________________________________ Mailing Address (if different) ________________________________________________________________ City, State, Zip Code _______________________________________________________________________ List each person who will be living in the household. Give legal name. Begin with yourself.
**White =1, Black =2, American Indian =3, Asian/Pacific Islander =4, Hispanic =5
List each person's source of income that will be living in the household. Begin with yourself.
Enter the assets that your household currently possesses, or has disposed of within the last two years for less than fair market value. Enter the anticipated or actual income from each asset next to Annual Income. Family Member Name_________________________________________ Source______________________________________________ Description of Asset____________________________________________ Contact______________________________________________ Cash Value__________________________________________________ Address______________________________________________ Annual Income_______________________________________________ City, State, Zip________________________________________ Family Member Name__________________________________________ Source______________________________________________ Description of Asset____________________________________________ Contact______________________________________________ Cash Value__________________________________________________ Address______________________________________________ Annual Income_______________________________________________ City, State, Zip________________________________________
Enter any Medical, Child Care or Handicapped Expenses that your household currently has.
1. Has anyone in your household been arrested or convicted for the use, sale, manufacture, or distribution of controlled substances (drugs) □ YES □ NO
2. Does anyone in your household currently use a controlled or illegal drug? □ YES □ NO If yes: Who? When? For What?_______________________________________________
3. Has anyone in your household ever been convicted of a felony or arrested for violent criminal activity? □ YES □ NO If yes: Who? When? For What?_______________________________________________
4. Does anyone outside your household pay for any of your bills or expenses? □ YES □ NO If yes: Who? When? For What?_______________________________________________
5. Do you or any family member claim handicapped or disabled status for eligibility purposes? □ YES □ NO
6.
Do you or a member of
your family request housing with special accommodations?
□ YES □ NO
Applicants who qualify for a special preference admission will be offered Section 8 assistance before those applicants who do not qualify for a special admission preference. Preference claims must be in effect and verified at the time assistance is offered. The preferences are as follows: Family Unification
Program Are you referred by the Department of Human Services Child Welfare? □ YES □ NO Non-Elderly Disabled Family Please be aware that the program definition of "disabled" must apply in order to be considered eligible for these special purpose admission vouchers. These vouchers are only available for non-elderly disabled families qualifying according to actual grant language. You must provide proof of legal disability to be considered for these preference points. One preference point will be awarded for non-elderly disabled adult status, one preference point will be awarded for non-elderly disabled adult transitional status. Are you and/or your spouse under the age of 65? □ YES □ NO Are you and/or your spouse disabled? □ YES □ NO Are you presently homeless? □ YES □ NO Are you presently living in transitional housing? □ YES □ NO Muskogee resident/Work Preference The Board of Commissioners of the Muskogee Housing Authority have approved the granting of one preference point for persons who live and/or work in the City of Muskogee city limits. You must provide proof of residence/work status in order to qualify for this preference point. Are you presently working and/or living in the City of Muskogee? □ YES □ NO Your eligibility to receive housing assistance is dependent upon your submitting to the Muskogee Housing Authority verification of your citizenship/national status or eligible immigration status. Verification for citizenship/national status will be supplied upon request. All contact by the Muskogee Housing Authority is made by mail, so if your address changes, please notify our office promptly. Remember, it is your responsibility to update your application information when needed. Warning! Title 18, Section 1001 of the United States Code, states that a person who knowingly and willingly make false or fraudulent statements to any Department or Agency of the U.S. government is guilty of a felony. I understand that any misrepresentation of information or failure to disclose information requested in the application my disqualify me from consideration for admission or participation, and may be grounds for eviction or termination of assistance. I do hereby certify that the above information is true, accurate, and complete to the best of my knowledge. Applicant_____________________________________ Date_____________________ Co-Applicant_____________________________________ Date_____________________ Other member over 18_____________________________________ Date_____________________ Other member over 18_____________________________________ Date_____________________ Before an offer of assistance is made to an applicant who has been selected from the waiting list on the basis of admission preference, the Housing Authority must require the applicant to provide verification that he or she qualifies for each of the preferences outlined above at the time of selection. The Housing Authority will verify the preference you claim at the time your name is selected from the waiting list. After completing,
mail, fax or drop off the pre-application to the Muskogee Housing Authority, If you believe you
have been discriminated against, you may call the Fair Housing and Equal
Opportunity |
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Muskogee Housing Authority 220 North 40`b Street Muskogee, Ok 74401 (918) 687-6301 FAX: (918) 682-0446 |
Section 8 Department |
VIOLENCE AGAINST WOMEN ACT (VAWA)
On January 5, 2006 the "Violence Against Women and Department of Justice Reauthorization Act of 2005" (Pub. L 109-162) was signed into law. Title VI of the new law adds a new housing subtitle to the existing Act, which protect victims of domestic violence, dating violence, sexual assault, and stalking. Under this Act, voucher individuals who are victims of these crimes will not be denied access to housing programs by the Housing Authority; will not evict victims of domestic violence related to their being abused; and victim confidentiality will be protected.
Selection
An applicant or participant who is or has been a victim of domestic violence, dating violence, or stalking is not an appropriate basis for denial of program assistance or for denial of admission of an otherwise qualified applicant.
Lease Terms Regarding Termination
An incident or incidents of actual or threatened domestic violence, dating violence, or stalking will not be construed as a serious or repeated violation of the lease by the victim or threatened victim of that violence and shall not be good cause for terminating the assistance, tenancy, or occupancy rights of the victim of such violence.
Termination of Assistance/Eviction
In HAP Contract: Criminal activity directly relating to domestic violence, dating violence, or stalking engaged in by a member of a tenant's household or any guest or other person under the tenant's control shall not be cause for termination of tenancy occupancy rights or termination of assistance if the tenant or an immediate member of the tenant's family is the victim or threatened victim of that domestic violence, dating violence, or stalking. The lawful occupant or tenant who engages in criminal acts of violence to family members or others must be removed from the assisted household for the victimized lawful occupants to continue to receive housing assistance. Court orders regarding rights of access or control of the property will be honored by the Housing Authority.
Owners, managers, or the Housing Authority may evict or terminate assistance for other good cause unrelated to the incident or incidents of domestic violence, provided that the victim is not subject to a "more demanding standard" than non-victims. Nothing is to prohibit termination or eviction if the owner, manager, or Housing Authority can demonstrate an actual and imminent threat to other tenants or those employed at or providing services to the property or public housing agency if that tenant is not evicted or terminated from assistance. This guidance shall not be construed to supersede any provision of Federal, State, or local law that provides greater protection than this section for victims of domestic violence, dating violence, or stalking.
Denial of Portability
The Housing Authority may not deny portable voucher assistance to a tenant who violated previous assisted lease terms solely in order to move out quickly because of the fear of domestic violence. The Housing Authority may not terminate or deny portable voucher assistance to a tenant who is otherwise in compliance with program rules moved out of a previous assisted unit in order to "protect the health and safety of an individual who is or has been the victim of domestic violence, dating violence, or staling and who reasonably believed he or she was imminently threatened by harm from further violence if he or she remained in the assisted unit."
Certification and Confidentiality
In order to qualify for the protections implemented in this Act and provide for the confidentiality of that certification, the individual must certify of his or her status as a victim of domestic violence, dating violence, or stalking.
Certification
An owner, manager, or Housing Authority may request that an individual certify via a HUD-approved certification form (when available) that the individual is a victim of domestic violence, dating violence, or stalking, and that the incident or incidents in question are bona fide incidents of such actual or threatened abuse and meet the requirements set forth in the aforementioned paragraphs. Such certification shall include the name of the perpetrator.
The individual shall provide such certification within 14 business days after the owner, manager, or Housing Authority requests such certification in writing. If the certification is not received within 14 business days of the administrator's written request, nothing would limit the administrator's ability to evict or terminate assistance.
Where no HUD-approved certification form is available, the individual may provide the owner, manager, or Housing Authority with documentation signed by an employee, agent, or volunteer of a victim service provider, an attorney, or a medical professional, from whom the victim has sought assistance in addressing domestic violence, dating violence, sexual assault, or stalking, or the effects of the abuse, in which the professional attests under penalty of perjury (28 USC 1746) to the professional's belief that the incident or incidents in question are bona fide incidents of abuse, and the victim of domestic violence, dating violence, or stalking has signed or attested to the documentation; OR by producing a Federal, State, tribal, or local police or court record.
Compliance with the certification requirements of this section shall not alone be sufficient to constitute evidence of an unreasonable act or omission by an owner, manager, Housing Authority, or assisted housing provider, or employee thereof.
Confidentiality
Information provided by the victim pursuant to the certification shall be retained in confidence and not entered into any shared database nor provided to any related entity except when the disclosure is consented to by the individual in writing, required for use in eviction proceedings, or otherwise required by law.
Notification of Rights and Obligations
Tenants under Section 8, owners, and managers will be notified of these rights and obligations via written notice sent via the U.S. Postal Service, and will also be posted in the public viewing area of the Section 8 office of the local housing authority.
I CERTIFY THAT I HAVE RECEIVED AND READ THE VAWA RIGHTS AND OBLIGATIONS AS OUTLINED ABOVE.
COMPLIANCE DECLARATION
I, do hereby swear and attest that all of the information regarding my household members and my household income is true, complete, and correct.
I also understand that all changes of income for any
member of the household must be reported within ten days of the change.I understand that I must report all changes to my household (persons moving out or children moving in) within ten days of the change.
I understand that I may not move any adult into the assisted rental unit unless they have first been approved by the Muskogee Housing Authority.
WARNING: TITLE 18, SECTION 1001 OF THE UNITED STATES CODE,
STATES THAT A PERSON IS GUILTY OF A FELONY FOR KNOWINGLY AND WILLINGLY MAKING FALSE OR FRAUDULENT STATEMENTS TO ANY DEPARTMENT OR AGENCY OF THE UNITED STATES.
THE HOUSING AUTHORITY OF THE CITY OF MUSKOGEE
SECTION 8 DEPARTMENT
220 North 40th Street
Muskogee, OK 74401
(918) 687-6301 EQUAL HOUSING OPPORTUNITY (918)682-0446 Fax
RELEASE OF INFORMATION FOR HOUSING CONSIDERATION
I
HEREBY VOLUNTARILY AUTHORIZE THE MUSKOGEE POLICE DEPARTMENT
OR ANY OTHER LOCAL, STATE OR FEDERAL LAW
ENFORCEMENT AGENCY TO RELEASE TO THE
HOUSING AUTHORITY OF THE CITY OF MUSKOGEE OR ITS
REPRESENTATIVES, IN CONNECTION WITH APPLICATION FOR HOUSING, A
COPY OF ANY CONVICTIONS AND/OR ARRESTS ON MY RECORD WITHIN
THE LAST TEN (10) YEARS FROM THE DATE OF THIS
RELEASE FORM, THIS INCLUDES CITY, COUNTY, N.C.I.C. AND I.I.I. WARRANT AND
CRIMINAL HISTORY BACKGROUND CHECKS.
APPLICANT'S FULL NAME: __________________________________________________________________________
OTHER NAMES USED BY APPLICANT (MARRIED,
MAIDEN, ETC.):________________________________________
ADDRESS:_________________________________________________________________________________________
CITY STATE
ZIP CODE
SOCIAL SECURITY#: ____________/_________/_____________ DATE OF BIRTH: _____________________
RACE: _____________________ GENDER: MALE _______ FEMALE ___________
HOME TELEPHONE#: (____) ____________________ DATE _______________________
________________________________________________________________________________________________________
PLEASE DO NOT WRITE BELOW THIS LINE - FOR OFFICE USE ONLY
________________________________________________________________________________________________________
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( )No arrest record ( ) No arrest record ( ) No arrest record |
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( ) Arrest record as follows ( ) Arrest record as follows ( ) Arrest record as follows |
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_____ Number misdemeanors _____ Number misdemeanors _____ Number misdemeanors |
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_____ Number felonies _____ Number felonies _____ Number felonies |
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_____ Number drug-related _____ Number drug-related _____ Number drug-related |
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( ) Attachments on back ( ) Attachments on back ( ) Attachments on back |
Comments: _____________________________________________________________________________________________
__________________________________
Muskogee Police Department
Signature and/or Stamp Required
Date completed: _____________________
