HomeMy WebLinkAboutFSS Interest Form A Updated 01-17
Harry Kim Neil S. Gyotoku
MayorHousing Administrator
County of Hawaii
OFFICE OF HOUSING AND
COMMUNITY DEVELOPMENT
1990 Kinoole Street, Suite 105 Hilo, Hawai’i 96720-5293
V/TT (808) 959-4642 FAX (808) 959-9308
FAMILY SELF-SUFFICIENCY (FSS) PROGRAM
INTEREST FORM (please write legibly)
All active Section 8 families are eligible,
Applications will be mailed to interested families,
Families shall go on the waiting list,
To receive help with higher education and/or job skills training
To receive help finding a job or increase in pay
To receive help working towards financial independence & self-
sufficiency
To receive tax free money in a secured FSS sponsored escrow account
FOR MORE INFORMATION CONTACT: HOW THE ESCROW ACCOUNT WORKS
Office of Housing and Community
EXAMPLE CURRENT WITH FSS
Development
Contract Rent $500 $500
Family Self-Sufficiency Program
Tenant Rent $100 $200
Attn: Glen Shigehara
Housing $400 $300
1990 Kinoole Street, Suite 105
Assistance
Hilo, Hawaii 96720
Phone: 959-4642
Fax: 959-9308 A portion of the $100 increase
in tenant’s rent goes into the
Escrow Account.
Detach Here
□ Yes, I am a Section 8 tenant and the Head of Household. I am interested
in the FSS Program.
Last Name: ______________________________________
First Name: _____________________________________
Phone number where I can be reached: ____________
Mailing Address: ________________________________
________________________________
□ Yes, I am interested in the FSS Program but I am not the Head of
Household.
Last Name: ______________________________________
First Name: _____________________________________
Phone number where I can be reached: ____________
Mailing Address: ________________________________
________________________________
IF YOU ARE INTERESTED – RETURN DETACHED PORTION TO THE
OFFICE OF HOUSING (address noted above) AND AN
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EQUAL HOUSING OPPORTUNITY
“HAWAI’I COUNTY IS AN EQUAL OPPORTUNITY
PROVIDER AND EMPLOYER”
APPLICATION FORM WILL BE MAILED TO YOU.