Forms Directory

This form, to be completed by the Head of the Household, will notify Berkeley Housing Authority of your intent to terminate your lease or tenancy. In this form you need to specify how you are serving the owner a 30-day notice — in-person, via mail, or electronically via this form. If you select the electronic option, you will need to enter the owner’s email address in order for this form to be sent to the owner of your unit.

In addition to completing this form, you will need to also submit the “Request to Transfer Voucher” form. You can access that form here.

After submitting this form, you will receive an email with a copy of the completed form for your records.

Tenants without any source of income must certify their circumstances using this form.

If you are an adult household member, your head of household is required to sign this form after you’ve filled it out. Please be prepared to provide your HOH’s email address so they can receive an email with a link to digitally sign. Once your HOH has signed, you will receive an email with a copy of the completed form for your records, which verifies that your form has been completed and sent to Berkeley Housing Authority.

This packet, to be filled out by the Head of the Household, is used to determine continued eligibility for the Section 8 program.

Before starting this packet, please complete the Notice of Right and Request for a Reasonable Accommodation form and then check your email for a copy of your completed form. To verify that you’ve completed the Notice of Right and Request for a Reasonable Accommodation, you will be required to upload that copy into this form.

Please be prepared to enter the email addresses of all adult household members when prompted. Each household member will then receive an email with a link to digitally sign the forms within this packet, as required. Once all signature requirements are fulfilled, you will receive a confirmation email with a copy of the completed form for your records.

Schedule an appointment with a Berkeley Housing Authority staff member.

After submitting this form, you will receive an email with a copy of the completed form for your records.

Please allow up to 3 business days for a response.

Issued by:
U.S. Department of Housing and Urban Development
Office of Public and Indian Housing
OMB Approval No. 2577-0249

Purpose of Form: The Violence Against Women Reauthorization Act of 2013 (“VAWA”) protects qualified tenants, participants, and applicants, and affiliated individuals, who are victims of domestic violence, dating violence, sexual assault, or stalking from being denied housing assistance, evicted, or terminated from housing assistance based on acts of such violence against them.

Use of Form: This is an optional form. A PHA, owner or manager presented with a claim for continued or initial tenancy or assistance based on status as a victim of domestic violence, dating violence, sexual assault, or stalking (herein referred to as “Victim”) has the option to request that the victim document or provide written evidence to demonstrate that the violence occurred.

The Victim has the option of either submitting this form or submitting third-party documentation, such as:

1. A record of a Federal, State, tribal, territorial, or local law enforcement agency (e.g. police), court, or administrative agency; or
2. Documentation signed by the Victim and signed by an employee, agent or volunteer of a victim service provider, an attorney, a medical professional, or a mental health professional from whom the Victim has sought assistance relating to domestic violence, dating violence, sexual assault, or stalking, or the effects of abuse, in which the professional attests under penalty of perjury (28 U.S.C. 1746) that he or she believes that the incident of domestic violence, dating violence, sexual assault, or stalking is grounds for protection under 24 Code of Federal Regulations (CFR) § 5.2005 or 24 CFR § 5.2009.
   • If this form is used by the Victim, the Victim must complete and submit it within 14 business days of receiving it from the PHA, owner or manager.
   • This form must be returned to the person and address specified in the written request for the certification.
   • If the Victim does not complete and return this form (or provide third-party verification) by the 14th business day or by an extension of the date provided by the PHA, manager or owner, the Victim cannot be assured s/he will receive VAWA protections.
   • If the Victim submits this form or third-party documentation as listed above, the PHA, owner or manager cannot require any additional evidence from the Victim.

Confidentiality: All information provided to a PHA, owner or manager concerning the incident(s) of domestic violence, dating violence, sexual assault, or stalking relating to the Victim (including the fact that an individual is a victim of domestic violence, dating violence, sexual assault, or stalking) shall be kept confidential by the PHA, owner or manager, and such information shall not be entered into any shared database. Employees of the PHA, owner, or manager are not to have access to these details unless to afford or reject VAWA protections to the Victim; and may not disclose this information to any other entity or individual, except to the extent that disclosure is: (i) requested or consented to by the Victim in writing; (ii) required for use in an eviction proceeding; or (iii) otherwise required by applicable law.

Submit a statement to Berkeley Housing Authority.

Quality customer service is an important element of our mission. We strive to get it right 100% of the time. Please use this form to share information about the services you received from Berkeley Housing Authority.

This form is to be completed by the Head of Household and must be submitted to the Berkeley Housing Authority (BHA) with all the proper documentation in order for a change to be considered.

After submitting this form, you will receive an email with a copy of the completed form for your records.

Please allow at least 30 days to process.

Section 8 Housing Choice Voucher Program: Tenant Protections After Foreclosure

Foreclosure Notice for Tenants

This packet, to be filled out by the Head of the Household, is required to report any changes in income, assets, or household composition, and should be submitted within 14 days of occurrence.

Before starting this packet, please submit the Family Notice of Change(s) form and then check your email for a copy of the completed form for your records. To verify that you’ve completed the Family Notice of Change(s), you will be required upload that copy into this form.

Please be prepared to enter the email addresses of all adult household members when prompted below. Each household member will receive an email with a link to digitally sign the forms within this packet, as required. Once all signature requirements are fulfilled, you will receive an email with a copy of the completed form for your records.

Please allow up to 30 days of processing.