Crescent City, CA · Del Norte County
Declaration of Section 214 Status
Applicants and tenants seeking housing assistance use this form to declare their status and return the signed declaration to the Crescent City Housing Authority.
What this form is
The Crescent City Housing Authority uses this declaration to verify the status of applicants and tenants seeking or receiving housing assistance. The signer checks the applicable statement, provides their name and date of birth, and signs and dates the form. Depending on the selected statement, the form calls for proof of age or immigration documents and a signed verification consent form.
Who needs it
Applicants for or recipients of housing assistance who are asked to declare their status must complete and return this form.
How to submit it
Sign and return the form to the Housing Authority’s Admissions Office at 235 H. Street, Crescent City, CA 95531. Include any supporting documents required by the statement you select.
About notarization
This declaration is signed without a notary and certifies the signer’s statement under penalty of perjury; required supporting documents and verification consent are not described as notarized.
How to submit this form
- 1
Download The Form
Download the Section 214 status declaration.
- 2
Complete The Declaration
Print or type your name and date of birth, check the appropriate statement, and sign and date the form.
- 3
Gather Supporting Documents
Attach proof of age or immigration documents and a signed verification consent form if required by your selected statement.
- 4
Return It To The Housing Authority
Return the signed form and any required attachments to the Housing Authority’s Admissions Office at 235 H. Street, Crescent City, CA 95531.
Frequently asked questions
- Who completes the Section 214 status declaration?
- Applicants for or recipients of housing assistance complete the form when asked to declare their status. An adult residing in the unit may sign for a child named on the statement.
- What supporting documents may be needed?
- Depending on the selected statement, the form calls for proof of age or immigration documents and a signed verification consent form.
- Do I need a notary for the Section 214 status declaration?
- No. The declaration is signed without a notary and is certified under penalty of perjury. The listed supporting documents and verification consent are not described as notarized.
- How do I submit the declaration?
- Sign and return it to the Housing Authority’s Admissions Office at 235 H. Street, Crescent City, CA 95531. Include any supporting documents required by your selected statement.