THE HOUSING AUTHORITY OF THE CITY OF MERCEDES



Preliminary Application for the Housing Choice Voucher Program

Please provide the information listed below, and we will begin reviewing your case.
On the next page you will be directed to download the complete application and fax it to us.
We will make contact with you after these steps are completed.

Name:

Home Phone:

Work Phone:

Email:

Mailing Address:

City:

State:

Zip:

Physical address where you currently live:


Please provide an alternate contact:


Name:


Phone number:

Household composition:

Number of adults (over age of 18) who will stay in the apartment:


Number of minors (under age of 18) who will stay in the apartment:


Does anyone in your household require special accommodations due to a handicap or disability?

If yes, specify what requirement is needed:

Income:

What is the combined estimated gross annual income of all occupants:







 

 

 

 

 

 

 

 

 

 

 

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