Recertification Packet

Rocky Mount Housing Logo.

1065 Pinehurst Drive | PO Box 4717 | Rocky Mount, NC 27803
Phone: 252.977.3141
Fax: 252.977.2587
Emergency After-Hours: 252.977.6223
Office Hours: Monday - Friday | 8:30 am - 5:00 pm

Certification for HUD Subsidized Rental Assistance Benefits

Please complete all sections of this certification and answer all questions. The answers provided on this document are utilized to determine your eligibility for rental assistance benefits subsidized through the U.S. Department of Housing and Urban Development (HUD). DO NOT leave any questions blank. If a question does not apply type "NA". If you do not understand a question, you may ask for an explanation or have someone else explain it to you. ALL adult members of the household must certify the information relating to them listed in this certification is correct.

ANY changes that take place after this form has been submitted to the Rocky Mount Housing Authority (i.e. between annual certifications) MUST be reported in writing within TEN (10) business days of the event occurring. Failure to do so may constitute a violation of your obligations under the rental assistance program and result in termination and/or criminal charges being filed against you.

Warning: Making false statements on this document is considered FRAUD and may result in TERMINATION from the program and CRIMINAL PROSECUTION.