Virginia Public Housing Nonpayment Income Options Insert
Virginia Public Housing Nonpayment Income Options Insert
Print this completed insert on pink or orange paper. Give it to the tenant with the public housing authority's notice of nonpayment of rent. Complete the four procedures below with the authority's current instructions before use; a contact name alone does not explain how to use an option. Va. Code § 55.1-1245(G).
Public housing authority: [FULL NAME]
Tenant and home or lot address: [NAME; STREET, UNIT OR LOT, CITY, VA ZIP]
Date sent with nonpayment notice: [__/__/____]
1. How to recertify your income
Request or submit recertification through: [OFFICE, PORTAL, TELEPHONE OR OTHER ACTUAL METHOD]
Form, information, and supporting documents to provide: [SPECIFIC AGENCY REQUIREMENTS]
Where and how to submit them: [ADDRESS, LINK, EMAIL OR DELIVERY INSTRUCTIONS]
Agency contact and hours: [NAME OR DEPARTMENT, PHONE, HOURS]
2. How to report a change in income
Report the change by: [SPECIFIC FORM, PORTAL, PHONE, IN-PERSON OR WRITTEN METHOD]
Information or proof to provide: [AGENCY REQUIREMENTS]
Where to send it and any agency deadline: [DESTINATION AND VERIFIED DEADLINE]
Contact for help or a receipt: [PHONE, EMAIL OR OFFICE]
3. How to request a minimum-rent hardship exemption
Submit a hardship request by: [SPECIFIC FORM OR WRITTEN/ORAL REQUEST METHOD ALLOWED BY THE AUTHORITY]
Describe the hardship and supply: [AGENCY'S ACTUAL INFORMATION REQUIREMENTS]
Where to send it and how to obtain help: [DESTINATION, PHONE, HOURS]
How the authority will respond and where to ask about status: [ACTUAL AGENCY PROCESS AND CONTACT]
4. How to file a grievance
File a grievance about the rent decision or these processes by: [SPECIFIC AGENCY METHOD AND FORM, IF ANY]
Where to submit it and any agency deadline: [DESTINATION AND VERIFIED DEADLINE]
How to request a hearing or review and contact the grievance office: [ACTUAL AGENCY STEPS, PHONE AND HOURS]
Accessible format or language help, if needed: [CONTACT AND REQUEST METHOD]
Authority completion and delivery record
The four current procedures above were checked by: [NAME AND TITLE] on [__/__/____].
Authority contact for questions: [PHONE, OFFICE ADDRESS, EMAIL]
Delivered with nonpayment notice by: [METHOD, DATE AND PERSON]
Posted in the authority's public housing community at: [CONSPICUOUS LOCATION(S) AND DATE(S)]
Authorized signature: ______________________________ Date: [__/__/____]
Official source
About this template
- Last updated
- November 6, 2026
- Citations checked
- November 6, 2026
- Jurisdiction
- Virginia
- Category
- Landlord & Tenant
Legal authority
- Va. Code § 55.1-1245(G) (version effective until July 1, 2027)
Landlord-tenant paperwork governs who can stay in a property, on what terms, and what happens when something goes wrong. Leases, notices to quit, security deposit demands, and habitability complaints all have state and often city-specific requirements for timing, content, and service. Getting the paperwork right is what makes an eviction actually succeed or a security deposit actually come back, because judges regularly dismiss cases over small procedural mistakes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on November 6, 2026.
Va. Code § 55.1-1245(G) (checked November 6, 2026): "G. If a public housing authority issues a notice of nonpayment of rent to a tenant, such public housing authority shall also provide to the tenant along with the notice of nonpayment written information printed on pink or orange paper explaining how the tenant may recertify the tenant's income, including how the tenant can, in accordance with federal law and policy, report changes in income, request a minimum rent hardship exemption, and file grievances. Such information shall be posted by the public housing authority in conspicuous locations in each public housing community under its authority."
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