Change of Household Composition

Haynesville Housing Authority
www.haynesvillehousing.org
Office: 318.624.1272
1953 Mill Street • PO Box 751 • Haynesville, LA 71038
Monday - Thursday 8:00 am - 6:00 pm

Fields marked with * must be completed or form will not submit.

Anyone you list as a household member must use the subsidized unit as their primary residence (at least 51% of the time). All adults must have an acceptable criminal background, cannot owe any housing authority money, and, if s/he previously participated in a federally subsidized housing program, must have acceptable compliance history. All adult additions must be approved in writing by your landlord and by Haynesville Housing before the additional person can move in.

Note: The fields at the bottom of this form marked "For Landlord Use Only" and "For HHA Use Only" should not be completed when submitting this form.