Residents: Decreased Employment Hours Form

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Phone: 864.855.0629 | Fax: 864.855.0864
103 Wallace Drive, Easley, SC 29640
EasleyHousing.org

[{"type":"text","required":true,"label":"Resident First Name","name":"resident-first-name","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Resident Last Name","name":"resident-last-name","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"text","required":true,"label":"Resident Unit","name":"Resident-Unit","className":"col-md-6 col-lg-3","subtype":"text"},{"type":"date","required":true,"label":"Date","name":"Date","className":"col-md-6 col-lg-3"},{"type":"text","required":true,"label":"Employer's Name","name":"Employers-Name","className":"col-lg-4","subtype":"text"},{"type":"text","required":true,"label":"Work Hours Decreased To","name":"Work-Hours-Decreased-to","className":"col-lg-4","subtype":"text"},{"type":"date","required":true,"label":"Date Of Last Paycheck","name":"Date-Of-Last-Paycheck","className":"col-lg-4"},{"type":"file","required":true,"label":"A Copy of Pay Stub Is Needed","name":"A-Copy-of-Pay-Stub-Is-Needed","subtype":"file","multiple":true,"className":"d-block"},{"type":"paragraph","subtype":"p","label":"(This form will allow upload of up to 20 files (35 Mb total of all files) in PDF, JPG or JPEG format.) ","className":"d-block"},{"type":"checkbox-group","label":"Have You Applied For The Following Assistance?","name":"Have-You-Applied-For-The-Following-Assistance","className":"d-block","values":[{"label":"Unemployment Benefits","value":"Unemployment-Benefits"},{"label":"Food Stamps","value":"Food-Stamps"},{"label":"AFDC","value":"AFDC"}]},{"type":"textarea","required":true,"label":"Do You Anticipate Any Additional Income During This Period That You Have Not Accounted For? ","name":"Do-You-Anticipate-Any-Additional-Income-During-This-Period-That-You-Have-Not-Accounted-For-","subtype":"textarea","className":"d-block"},{"type":"text","required":true,"label":"Signature","name":"Signature","className":"d-block","subtype":"text"}]