Cumberland Housing Authority

Change of Income/Household Report Form
Section 8 Housing Choice Voucher Program

Section 8 Housing Choice Voucher Program participants are required to report all income changes within 10 days of the change. Please use this form to report any income changes for current household members. Once this form is received by Cumberland Housing Authority you will be contacted by your Housing Choice Voucher representative.

Increase in Income/Change of Income

Name of new or additional source of income/employer Amount of increase in income Date new or additional income began

Decrease in Income/Loss of Income

Name of source of income/employer Amount of decrease of income Date income decreased/ended
NoYes
By checking the "I agree" box below, I certify that the information reported on this form is true and correct. I understand that giving false, incomplete, and/or inaccurate information is punishable under Federal and State law and is grounds for termination from the Section 8 Housing Choice Voucher Program.
I Agree