Rent, water and other charges

Request a rent assessment form - public housing

Housing SA will use this information to send you a form. You will need to complete the form 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.

Required fields are marked with an asterisk (*).

Housing SA customer number *

Full name *

Address *

Postal address (if different from above)

Phone number *

Reason * 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

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Provided by: Department for Communities and Social Inclusion

Page last updated 30 November 2016

Provided by:

Department for Communities and Social Inclusion

URL:

https://www.sa.gov.au/topics/housing/public-and-community-housing/tenants/rent-water-and-other-charges/request-a-rent-assessment-form

Last Updated:

30/11/16

Printed on:

26/09/17

Request a rent assessment form - public housing

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