2023 Resident Census
 

2023 Resident Census

 

According to the CCA bylaws, Article IX, Section 9.3, and the Federal Fair Housing Amendments Act, you required to answer the following questions.  The information you provide will be treated with strict confidentiality. In order to comply with the regulations of the Department of Housing and Urban Development, this survey must be completed fully and returned to the administration office.

 

Every person residing in the unit must be listed when completing the census, including live-in home aides who will be considered full-time, permanent residents.  Even though the governing documents require a resident to be 55 years of age or more, the Federal Fair Housing Act mandates reasonable accommodation be offered for residents who are disabled to have home aides reside in the unit.  If your home aide is under the age restriction requirement, you will be asked to write a letter requesting reasonable accommodation to the CCA Board of Directors.

 

Proof of age for ALL residents, including home health aides, must be provided with this form.  Acceptable forms of ID are any of the following: birth certificate, driver’s license, passport, state issued ID card, military discharge papers, or some other government issued document.  If we have your document on file, a copy is not necessary. You can contact the office if you are unsure about a copy being on file.


DO NOT PRINT THIS E-FORM, PLEASE ONLY HIT SUBMIT ONCE COMPLETED.  IF YOU NEED A PRINTABLE FORM, THEY ARE LOCATED UNDER RESOURCES AND DOCUMENTS AND FORMS!




Section:*
Address:*
Phone #:*
Email Address:*
Name 1:*
Date of Birth 1:*
Name 2:
Date of Birth 2:
Name 3:
Date of Birth 3:
Name 4:
Date of Birth 4:
Is anyone in the unit homebound requiring help in an emergency?:*
Person to Contact in Case of Emergency (Not Living with you in the household):*
Contact's Relationship:*
Contacts Phone Number:*
Contacts Alt Phone Number:
Signature - By typing your name you are acknowledging that all information is correct and accurate:*
Acceptable ID if not on file:
To prevent automated SPAM, please enter XHL2 to submit your form (case sensitive):*
 

* indicates required field

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