Follow the steps to complete your client intake form with ease.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Begin with the primary applicant information section. Fill in your first name, middle initial, last name, city, state, zip code, and contact information, including home and cell phone numbers and email address. Ensure you select your preferred method of contact.
3. Indicate the number of individuals residing in your household and specify how many of them receive income. Additionally, select whether you have a disability and your housing choice voucher status.
4. Provide information related to your residence type, such as whether you rent or own your home, your birthdate, and military status.
5. If applicable, fill out the co-applicant section with their personal and contact details. Include their relationship to you, disability status, and residency information.
6. List all household members by providing their names, ages, and their relations to you in the designated section.
7. Complete the income section by detailing all sources of income from employment, government benefits, and other relevant sources. Include the employer name, job title, and income frequency.
8. Fill in the liabilities and debts section, detailing each creditor, type of debt, remaining balance, monthly payment, and how many months behind you are.
9. List your fixed expenses, such as rent/mortgage, utility bills, insurances, and other recurring payments. Be accurate in reporting your monthly amounts.
10. Document your flexible expenses, which may include savings, groceries, entertainment, and other variable costs. Ensure to estimate these amounts correctly.
11. Review all information you have entered for accuracy. Sign and date the form to certify that the information provided is correct and acknowledge your understanding of the terms.
12. Finally, submit the completed intake form by email to housingcounseling@piedmonthousing.org, fax it to 434-817-0664, or deliver it in person to the specified address.

Ready to access housing assistance? Complete your VA Piedmont Housing Alliance Client Intake Form online today.