Date: ________________ Effective Date of change: ______/1/2022_______
I (We), _______________________________________________________________________
(Name(s) listed on IRS Form W-9)
am (are) the new Property Owner(s)/Manager(s) of the housing unit(s) located at:
_ ___________________________________
(Address Range) (Street) (Ave. /St. /etc.) (City, State) (ZIP Code)
The following are the HCV Program participants who reside at the property:
___________________________________ _____________________________ ______ ________
Name Property Address Unit # ZIP Code
___________________________________ _____________________________ ______ ________
Name Property Address Unit # ZIP Code
___________________________________ _____________________________ ______ ________
Name Property Address Unit # ZIP Code
___________________________________ _____________________________ ______ ________
Name Property Address Unit # ZIP Code
I (We) intend to carry out the terms and conditions listed in the current lease and HAP Contract.
I (We) have attached all required documentation.
_______________________________________________________________ _________
Signature of New Property Owner/Manager Date
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Office Use Only:
_______________________________________________________________ __________
Administrator Signature Date
Previous Owner #: _________________
310 N Commerce Park Loop. P.O. Box 27210 Tucson, AZ 85726-7210
Phone (520) 837-5322 Fax (520) 791-5201 TTY: (520) 791-2639
Elisa.Gracia@tucsonaz.gov
If you should require an accommodation or alternative arrangements due to a disability, please call (520) 791-4739.
If you require an oral interpretation in a language other than English, please call (520) 791-4739.
Si requiere una interpretación oral en un idioma que no sea inglés, por favor llame al (520) 791-4739.