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Housing, property and land

Request a rent assessment form

* Mandatory fields

Complete the following information and press the submit button. Housing SA will then use this information to send you a form. You will need to complete the form sent to you and provide proof of income for everyone in the household aged 21 years or older. Completed forms can be lodged by post or at any Housing SA office.

Housing SA customer number: *

Full name: *

Address: *

Postal address (if different from above):

Phone number: *

Please indicate your reason(s) for requesting the form, providing more information in the box below.

My income has changed

The income of a household member has changed

Someone is moving in or out

Other

More information: