Crescent City, CA · Del Norte County
Family Member Move-Out Notification
Households use this notification to report a family member moving out to the Crescent City Housing Authority and provide updated household information.
What this form is
This notification tells the Crescent City Housing Authority that a family member has moved out of the household. The head of household provides the former member’s name, move-out date, new address and phone number, and indicates whether household income changed. The form also asks for contact information for someone who can substantiate the new address and includes a statement about reporting household changes.
Who needs it
A head of household should use this form to notify the Crescent City Housing Authority when a family member moves out.
How to submit it
Submit the completed notification to Crescent City Housing Authority, 235 H Street, Crescent City, CA 95531. The form lists 707-464-9216 and fax 707-464-2692.
About notarization
This notification is signed and dated without a notary; the signer initials the receipt, and no notarized or sworn attachment is identified.
How to submit this form
- 1
Download The Notification
Download the Family Member Move-Out Notification PDF.
- 2
Complete Household Details
Enter the head of household’s contact information and the former household member’s name, move-out date, new address, and phone number.
- 3
Provide Change Information
Indicate whether household income changed and provide a contact who can substantiate the former member’s new address.
- 4
Sign And Submit
Sign and date the notification, initial the receipt, and submit it to Crescent City Housing Authority at the address on the form.
Frequently asked questions
- What does the Family Member Move-Out Notification report?
- It reports a family member’s move-out to the Crescent City Housing Authority and collects the person’s new contact details, any resulting household income change, and a reference who can substantiate the new address.
- Who completes this notification?
- The head of household provides household and former-member information, signs and dates the notification, and initials the receipt.
- Do I need a notary for the Family Member Move-Out Notification?
- No. This document is signed and dated without a notary; the signer initials the receipt, and the form identifies no notarized or sworn attachment.
- How do I submit the Family Member Move-Out Notification?
- Submit it to Crescent City Housing Authority, 235 H Street, Crescent City, CA 95531. The form also lists a phone number and fax number.