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Income Change Request Form - HA Property

The Housing Authority of the County of Santa Barbara Logo

Phone: 805-736-3423 | Fax: 805-735-7672
815 West Ocean Avenue, Lompoc, CA 93436
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Please fill out the form below if you have experienced a loss or change in income. A staff member will reach out to you as soon as possible. Please include as much detail as possible.

* = required fields.

Please submit online or print the completed form with supporting documentation and drop off at any of our drop box locations listed below:

Santa Maria
Evans Park -
200 W Williams St

Central Plaza -
200 N McClelland St Rancho

Hermosa -
235 E Inger Dr

Housing Office -
5575 Armitos Ave

Sandpiper Apartments -
375 Ellwood Beach Dr

Positano Apartments -
11 Camino De Vida

Pescadero Lofts -
761 Camino Pescadero

Administration -
815 W Ocean Ave

Housing Office -
817 W Ocean Ave

Lompoc Terrace -
904 W Walnut Ave

Parkside Gardens -
240 W Pine St

Homebase on G -
513 North G St

Cypress Court -
125 South 7th St

Creekside Village -
260 Gonzales Dr, Los Alamos
Decrease of Income
Increase of Income (New Job)
Change in Current Employment (Raise, Shift Differential, Bonus, etc.)
Increase/Decrease of Income Benefits
Adding/Removing an Adult (18+) Household Member
Adding a Minor Household Member
Removing a Minor Household Member
No Longer a Full-Time Student
Becoming a Full-Time Student
In Kind Income (Family/Friend Support)

Amount Frequency *

Child Support Increase/Decrease
Supporting documentation is not required to submit this form but documentation will be required during the verification process. If documentation is submitted with the form, the verification process will move faster. *

The reported change will be effective on the first day of the next month.

I certify under penalty of perjury that the reported change(s) are true and correct and any additional changes will be reported immediately.