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Region XII
Regional Housing Authority
320 E 7th Street, PO Box 663
Carroll, IA 51401
Phone: 1-712-792-5560
Fax: 1-712-792-1650​
Rental Assistance Forms
APPLICANTS:
Rental Assistance Application: Contact our office about obtaining and completing an application. All Applications must be returned IN PERSON. Please bring birth certificates and social security cards for all household member along with current government issued photo IDs for all adults (18+ years old) in the household. ALL ADULTS must come to sign additional paperwork required for a COMPLETE application to be accepted and placed on the waiting list. Applications WILL NOT be accepted by mail, email, fax, etc.
PARTICIPANTS:
Income/Asset Form (for annual renewals): We must re-evaluate your household/financial situation on an annual basis, use this form to renew your HCV contract.
Release of Information: Consent form for verifying income/asset resources. Must be signed annually.
Family Obligations: Your responsibilities as a rental assistance applicant/tenant. Must be signed annually.
Change Form: Use to report any household or financial change.
Intent to Vacate form: Are you planning to move? Complete and return this form 30 days before your move out date. If you want to take your assistance with you, call our office - more paperwork will be required.
LANDLORDS:
Rent Increase Form: Landlords may use this form to request a rent increase for tenants who are currently receiving rental assistance. Landlords are not allowed to raise rents in the first 12 months of a rental assistance contract. Region XII Regional Housing Authority requires a 60 day written notice of the rent increase.
Request for Tenancy Approval: All tenants who have a current voucher should have a copy of this form. This form is used to inform the housing authority that the tenant has found a unit they are interested in renting. The form should be completed in its entirety for our inspectors to review and determine if the unit is financially reasonable for the tenant. This form is also required before our inspectors will schedule an inspection on any unit.
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