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TENANT INFORMATION FORM <br />Please review and complete this form. This information will help us determine your assistance. <br />Indicate the current status of all adults and children that will live in the housing unit to be assisted. Add new members in the space <br />provided below, including the full Social Security Number for each. Enter one of the following codes in box 6 to identify the <br />relationship of each new adult and child listed. <br />H = Head of Household <br />S = Spouse (Married) <br />K = Co-Head (Not Married) <br />F = Foster Child/Adult <br />Y = Youth Under 18 <br />E = Full Time Student Over 18 <br />L = Live-in Aide <br />A = Other Adult <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex 6. Relation <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />Telephone Number: <br />Part 1: Household Information <br />Telephone Number: <br />E-mail Address I would like to receive correspondence via e-mail. <br />Head of Household <br />Unit Address <br />Unit City, State, ZIP <br />Mailing Address (if <br />different than above) <br />H <br />11. Living in Household <br />NoYes <br />FM Y N <br />2 <br />1 <br />4 <br />3 <br />2 <br />5 <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />6. Relation <br />11. Living in Household <br />NoYes <br />FM Y N <br />1 2 <br />1 <br />4 <br />3 <br />2 <br />5 <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex 6. Relation <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />11. Living in Household <br />NoYes <br />FM Y N <br />1 2 <br />1 <br />4 <br />3 <br />2 <br />5 <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex 6. Relation <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />11. Living in Household <br />NoYes <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex 6. Relation <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />11. Living in Household <br />NoYes <br />1. Last Name & Sr, Jr, etc.2. First Name 3. MI 4. Date of Birth 5. Sex 6. Relation <br />10. Social Security Number <br />7. Disabled <br />NoYesFM <br />Native Hawaiian/ <br />Other Pacific Islander <br />9. Race (Check All That Apply)8. Ethnicity (Check One Box) <br />Not Hispanic/ <br />Latino <br />Hispanic/ <br />Latino <br />White <br />Black/African American <br />American Indian/Alaska Native <br />Asian <br />11. Living in Household <br />NoYes <br />Home Work Cell Other______________ <br />Home Work Cell Other______________ <br />1 <br />Page 8 of 29 <br />EXHIBIT 2