Transcription of Portability Request I, would like to request a transfer to
1 Portability Request I, _____ would like to Request a transfer to: Name of Housing Authority: _____ Address: _____ Phone #: _____ Fax #: _____ I understand that a clearance letter from my landlord and a signed voucher is required before my paperwork can be transferred to the receiving housing authority stated above. _____ _____ Tenant Signature Date ---------------------------------------- ---------------------------------------- ------------ FOR OFFICE USE ONLY TENANT NAME: _____ SOCIAL SEC #:_____ VOUCHER #:_____ BR SIZE:_____ COUNSELOR:_____
