Public Housing Pre Application – Covington Housing Authority

Tell Us About The Head Of Household

(You’ll add your family members later)
Your Name
First Middle Last
Gender
Social Security Number
Birth Date – must be mm/dd/yyyy format
MM slash DD slash YYYY
Race(s) (select all that apply)
Ethnicity
Are you a U.S. Veteran?
Are you disabled?
Phone Number
Email
Best method to contact you
ALL WAITING LISTS ARE CLOSED AND NO APPLICATIONS ARE BEING ACCEPTED UNTIL FURTHER NOTICE.
Hidden
Golden Tower
- Golden Tower (Senior Community) – 50E 11th Street, Covington KY 41011
Hidden
New Site Properties
- NSP (New Site Properties) 2-3 Bedroom
Hidden
City Heights
- City Heights- 2500 Todd Street, Covington, KY 41011

Tell Us About Your Family

Provide information for the individuals who will live with you in your household.
How many family members (NOT including yourself) will be on this application?

Tell Us About Your Family Members

Name	Gender	Relationship to Head Of Household	Social Security Number	Birth Date	Race(s) (select all that apply)	Ethnicity	Family member is a U.S. Veteran	Family member is disabled.	Actions

There are no Entries.

Provide information for the individuals who will live with you in your household.

Tell Us About Your Family’s Income…

Please include income from all family members

Add Income for each Family Member

Whose income is it?	Type of Income	Who do you receive it from?	How much do you receive? (Gross Amount)	How often do you receive it?	Actions

There are no Entries.

Tell Us About Your Family’s Assets…

Please include assets from all family members

Add assets for all Family Members

Whose asset is it?	Type of Asset?	Description/Source (Name of Bank, Name of Insurance Company, Location of Real Estate, etc.)	What is it worth? (Amount)	Actions

There are no Entries.

Tell Us About The Head Of Household