Who uses the Change of Household Income form?

Households receiving assistance from the Crescent City Housing Authority use it to report an increase or decrease in income.

What information does the form ask for?

It asks who experienced the income change, when it occurs, the new amount and frequency, and whether other household income will be affected.

Do I need a notary for the Change of Household Income form?

No. The form has a signature and date line but no notary block; it does not identify any attachment or related step that must be notarized or sworn.

How do I submit the Change of Household Income form?

The form lists the Crescent City Housing Authority's address and fax number but does not specify a submission method.

Crescent City, CA · Del Norte County

No notary required

Notification of Change in Income

Crescent City Housing Authority participants use this form to report a change in household income and provide details about the change.

What this form is

This form notifies the Crescent City Housing Authority of an increase or decrease in household income. It asks who experienced the change, when it takes place, the new amount and payment frequency, and whether other household income will be affected. The form states that income changes must be reported immediately and that the Authority may take up to 30 days to process a reported change.

Who needs it

A household receiving assistance from the Crescent City Housing Authority should use this form to report a change in income.

How to submit it

The form lists Crescent City Housing Authority at 235 H Street, Crescent City, CA 95531, and a fax number, but does not specify how to submit it.

About notarization

This document is signed without a notary; it includes a signature and date line, and does not identify any attachment or related step that must be notarized or sworn.

How to submit this form

1
Download The Form
Download the Change of Household Income form.
2
Complete The Form
Enter the household and income-change details requested, then sign and date the form.
3
Gather Supporting Documents
The form includes spaces for tenant-submitted documents and documents needed; it does not specify which documents to attach.
4
Submit To The Housing Authority
The form lists the Crescent City Housing Authority's address and fax number but does not state how to submit it.

Frequently asked questions

Who uses the Change of Household Income form?: Households receiving assistance from the Crescent City Housing Authority use it to report an increase or decrease in income.
What information does the form ask for?: It asks who experienced the income change, when it occurs, the new amount and frequency, and whether other household income will be affected.
Do I need a notary for the Change of Household Income form?: No. The form has a signature and date line but no notary block; it does not identify any attachment or related step that must be notarized or sworn.
How do I submit the Change of Household Income form?: The form lists the Crescent City Housing Authority's address and fax number but does not specify a submission method.

Need something notarized?

This Notification of Change in Income doesn’t need a notary — but if you have another Crescent City form that does, a commissioned online notary can help.