550113 JP 10/6/05
HOUSING CHOICE VOUCHER EXTENSION REQUEST FORM
Under the Section 8 Housing Choice Voucher Program, participants have 60 days to find a suitable unit when they are
first issued a voucher, or when they have moved out of assisted unit. If you have not been able to locate a suitable unit
within this timeframe, you may request an extension from the Housing Authority. If you wish to receive an extension,
you must make the request in writing. Requests for an extension must be received at least seven (7) calendar days
before the expiration of your voucher, or your voucher transfer deadline. If you do not request an extension by
this due date, your participation in the Section 8 Housing Choice Voucher Program will be terminated.
PLEASE USE THE FORM BELOW TO REQUEST ADDITIONAL TIME TO SEARCH FOR A UNIT.
Name of Head of Household:
__________________________________________ Tenant ID:
Home Address: __________________________________ Mailing Address: ________________________________
Phone Numbers: Home: _____________________ Work: _____________________ Cell: _____________________
Email Address: ____________________________________________________________________________________
Please state the reason that you have not been able to locate a suitable unit within 60 days:
IMPORTANT – Please include a copy of your Family Contact List with this request.
When the Housing Authority receives your Housing Choice Voucher Extension Request Form, we will evaluate your
request. Extensions are not granted automatically. If your request is denied, and you have not submitted an RTA to the
Housing Authority by the expiration of your voucher or your voucher transfer deadline, your participation in the Section
8 Housing Choice Voucher Program will be terminated.
If the Housing Authority approves your request, you will receive up to 60 additional days to find suitable housing.
However, if an extension is granted, in addition to submitting an RTA on or before the last day of your extension period,
your new unit must pass inspection, and your lease must begin within seven (7) calendar days of your extension
deadline. Therefore, even if you submit an RTA within the designated timeframe, if the unit is not available for
inspection, does not pass inspection, or if any other factors delay the beginning of your lease more than 7 calendar days
past your extension period, you will lose your housing assistance and be terminated from the program. Therefore, we
strongly urge that you find a unit and submit an RTA as soon as possible.
Print Head of Household Name Signature of Head of Household Date