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The Champaign Housing Authority

Change of Family Composition – Add Minor

In an effort to ensure you and your household are served in a timely manner, we request that you completely fill out and sign every document in the enclosed packet. Warning: Failure to report a change of family composition could result in termination of your housing assistance.

To add a member to your household, you must enclose copies of the following for all persons being added:

  1. Social Security Card
  2. State issued Birth Certificate
  3. Proof of custody or guardianship
  4. TANF, Social Security/SSI and Child Support print outs (if applicable)
  5. Proof of any other income for new member 

The following forms should be completed by Head of Household:

  1. Add a New Household Member Form (must be completed by Head of Household)
  2. Statement form (stating change you are requesting).
  3. Authorization for Release of Information – Privacy Act Notice (must be signed by Head of Household)
  4. Citizenship (Declaration of Section 214 Status form) Note: Child's Name should be in the first blank, citizenship status should be checked and the Head of Household should sign, date and check the box indicating they are signing for a minor.

The following forms should be completed by your current Landlord:

  1. Owner Acknowledgement

FAILURE TO SUBMIT THE REQUIRED DOCUMENTATION MAY DELAY YOUR REQUEST TO ADD A MEMBER TO YOUR HOUSEHOLD.