Client Statement

Client Statement

Submit a statement to Berkeley Housing Authority.

"*" indicates required fields

Name*
Email*
Name of Head of Household*
Your Address*
You, as a client of Berkeley Housing Authority, certify that the information you provide below is true and correct to the best of your knowledge.

WARNING: Title 18, Section 1001 of the United States Code, states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department or agency of the United States.

MM slash DD slash YYYY

 

Berkeley Housing Authority logo

Berkeley Housing Authority
1947 Center Street Fifth Floor, Berkeley, CA 94704
Telephone: (510) 981-5470   Fax: (510) 981-5480