Skip to Main Content
The Champaign Housing Authority

Change of Family Composition – Remove Member

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 remove a member of your household you must enclosed the following:

  1. Legal evidence of new address for each household member being removed. Examples of acceptable verification include the following: 
    • Legal evidence of divorce or legal separation
    • Order of protection/restraining order obtain by one family member against another
    • Lease or rental agreement showing the individual listed as a member of another household
    • Document from court or correctional facility stating how long they will be incarcerated.
    • Current photo ID for member being removed that shows their new address.

The following forms should be completed by Head of Household:

  1. Remove Household Member Form (must be completed by Head of Household and signed 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).

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