Member Service
Resume:
Fort Wayne Housing Authority
Wayne IN 46816
Online Application Summary
Profile
Rafia Mack
4925parktownway
Apt.16
Montgomery, AL 36116
Applied Date: 8/2/2022 8:25:47 PM
Application Status: Submitted
Office:
Home: 901-***-****
Mobile: 334-***-****
E-mail: ***********@*****.***
Income
Annual Income: 0.00
Special Needs Access
Displaced
X Homeless
None
Hearing Access
Mobility Access
Sight Access
X None
Other Details
According to the above bedroom chart, what is your preferred bedroom size?
4
Do you or any member of your household require
interpretation services?
No
Do you or any member of your household require any modification(s)/accommodations(s) to fully participate in this or any FWHA program or service? i.e. Ground floor unit, large print documents, wheelchair ramp, shower bars, etc.?
No
Are you or a member of your household a victim of
domestic violence?
No
Are you or any member of your household required to register as a sex offender?
No
Household Information
Name Member Age Gender Race Ethnicity Citizenship
Fort Wayne Housing Authority
7315 Hanna Street Fort
Wayne IN 46816
Preferences Waiting List
Description Status Reason
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