Housing Help Center Intake Form




Contact Information





If you do not have an email address, please input yourname@noemail.com

Input your street address and apartment number(if applicable)




General Information





Location Information


Current Living Situation






Input value without commas

Rent/Mortgage Information




Input value without commas

Input value without commas




Move-In Assistance

Input your street address and apartment number(if applicable)





Input value without commas

Input value without commas

Input value without commas




Utilities


Input value without commas

Input value without commas

Input value without commas

Input value without commas

Input value without commas

Input value without commas

Income/Documentation



Input income for the full year without commas

Household information








Background Information







For questions about this form, please contact: 
help.housinghelpcenter@atlantaga.gov