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Cliffside Park Housing Authority

500 Gorge Road Ste #1, Cliffside Park, NJ, 07010, US


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Date Picker

Full Name of Household Member

Household Member's Full Address

Household Member's Full Address

I certify that I am not currently working. I understand that if I do obtain employment in the future, I must report the change to my case worker at the Cliffside Park Housing Authority within ten days of employment. 

It is further understood that if it is subsequently discovered that I have withheld or provided false or misleading information that it may result in the termination of my participation in the Housing Choice Voucher Program. 


Signature of Head of Household

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