Who needs to sign this notice?

Each adult household member must sign page 2 to acknowledge that the PHA provided the notice.

Do I need a notary for the Debts Owed to Public Housing Agencies and Terminations notice?

No. Each adult household member signs and dates page 2; the notice does not state that any attachment or related step must be notarized.

How do I submit the signed notice?

The notice identifies the PHA that provided it but does not give a return method. Submit it to the city department named on the form; check the city website for current contact details.

Pasadena, TX · Harris County

No notary required

Debts Owed to Public Housing Agencies and Terminations

This HUD notice explains how debt and termination information may be used and lets adult household members acknowledge receipt for rental assistance.

What this form is

Public Housing Agencies provide this notice to applicants and participants in listed HUD rental assistance programs. It explains what debt and termination information HUD collects, who can access it, how it may affect assistance, and the reader’s rights. Each adult household member must sign page 2 to acknowledge receiving the notice.

Who needs it

Each adult household member applying for or participating in a listed HUD rental assistance program must sign page 2 to acknowledge receipt.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This notice is signed and dated without a notary; each adult household member signs page 2, and no notarized attachment or related step is stated.

How to submit this form

1
Download the Notice
Download the Debts Owed to Public Housing Agencies and Terminations notice.
2
Read the Notice
Review the information about HUD records, how PHAs may use them, and your rights.
3
Sign and Date Page 2
Each adult household member signs and dates page 2 to acknowledge receipt.
4
Submit the Signed Notice
Return it to the PHA that provided the notice; the document does not specify a return method.

Frequently asked questions

What is the Debts Owed to Public Housing Agencies and Terminations notice?: It explains the information HUD collects about household members and adverse debt or termination history, how PHAs may use it, and the rights of applicants and participants.
Who needs to sign this notice?: Each adult household member must sign page 2 to acknowledge that the PHA provided the notice.
Do I need a notary for the Debts Owed to Public Housing Agencies and Terminations notice?: No. Each adult household member signs and dates page 2; the notice does not state that any attachment or related step must be notarized.
How do I submit the signed notice?: The notice identifies the PHA that provided it but does not give a return method. Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Debts Owed to Public Housing Agencies and Terminations doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.