Form MDC-0054 "Request for Voucher Extension" - Miami-Dade County, Florida

What Is Form MDC-0054?

This is a legal form that was released by the Public Housing & Community Development - Miami-Dade County, Florida - a government authority operating within Florida. The form may be used strictly within Miami-Dade County. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2014;
  • The latest edition provided by the Public Housing & Community Development - Miami-Dade County, Florida;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form MDC-0054 by clicking the link below or browse more documents and templates provided by the Public Housing & Community Development - Miami-Dade County, Florida.

ADVERTISEMENT
ADVERTISEMENT

Download Form MDC-0054 "Request for Voucher Extension" - Miami-Dade County, Florida

Download PDF

Fill PDF online

Rate (4.7 / 5) 15 votes
                                               
 
 
Public Housing and Community Development
Miami‐Dade Housing Choice Voucher Program
P.O. Box 521750
Miami, FL 33152‐1750
 
TTD/TTY Florida Relay Service
Carlos A. Gimenez, Mayor 
1‐800‐955‐8771 or Dial 771
www.miamidade.gov  
Customer Service Number: 305‐403‐3222/ Fax: 786‐358‐5893
Si necesita ayuda con este formulario, llame al 305‐403‐3222
Si w bezwen asistans ak fòm sa a, tanpri rele 305‐403‐3222
 
REQUEST FOR VOUCHER EXTENSION 
 
A family may request a thirty (30) day extension(s) to the initial sixty (60) day term of an issued Voucher. All requests for extensions 
should be received at least one week prior to the expiration date of the voucher. The request must be submitted in writing to our 
P.O. Box, Fax or delivered to our office to the attention of Voucher Extension Request. Extensions are permissible at the discretion of 
MDHCVP primarily two reasons, as follows: 
 
EXTENUATING CIRCUMSTANCE
1.
Extenuating circumstances such as hospitalization of a family member or a family 
emergency over an extended period of time that has affected the family’s ability to find a unit within the initial (60) day 
term.  
REASONABLE ACCOMODATION FOR AN ACCESSIBLE UNIT
2.
As a reasonable accommodation for a family 
  
member with disabilities or for a family member with disabilities to find an accessible unit.
 
Entity ID: 
HOH Name: 
Telephone Number: 
Email Address: 
 
Please select below the reason for your request for a voucher extension. 
 
EXTENUATING CIRCUMSTANCE
  
 
       Briefly explain nature of circumstance: _______________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
 
REASONABLE ACCOMODATION FOR AN ACCESSIBLE UNIT
  
 
       Briefly detail accessibility requirements: ______________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
 
Signature: ________________________________________ 
 
Date: _____________________________ 
FOR MDHCVP USE ONLY 
 
Original Issue Date: _______________________   
Original Expiration Date: _____________________________ 
Is this the first Extension Request? 
 Yes 
 No  
If No selected, provide the first voucher extension issue date: _______________  Expiration Date: ___________________ 
New Issue Date: ____________________________ 
 
New Expiration Date: ____________________________ 
 
Check below if applicable: 
 
FINAL VOUCHER EXTENSION
 
 
Approved By: ________________________________________   
Date: __________________________________ 
MDC‐0054 Request for Voucher Extension 
 
 
 
Rev. 11/2014
                                               
 
 
Public Housing and Community Development
Miami‐Dade Housing Choice Voucher Program
P.O. Box 521750
Miami, FL 33152‐1750
 
TTD/TTY Florida Relay Service
Carlos A. Gimenez, Mayor 
1‐800‐955‐8771 or Dial 771
www.miamidade.gov  
Customer Service Number: 305‐403‐3222/ Fax: 786‐358‐5893
Si necesita ayuda con este formulario, llame al 305‐403‐3222
Si w bezwen asistans ak fòm sa a, tanpri rele 305‐403‐3222
 
REQUEST FOR VOUCHER EXTENSION 
 
A family may request a thirty (30) day extension(s) to the initial sixty (60) day term of an issued Voucher. All requests for extensions 
should be received at least one week prior to the expiration date of the voucher. The request must be submitted in writing to our 
P.O. Box, Fax or delivered to our office to the attention of Voucher Extension Request. Extensions are permissible at the discretion of 
MDHCVP primarily two reasons, as follows: 
 
EXTENUATING CIRCUMSTANCE
1.
Extenuating circumstances such as hospitalization of a family member or a family 
emergency over an extended period of time that has affected the family’s ability to find a unit within the initial (60) day 
term.  
REASONABLE ACCOMODATION FOR AN ACCESSIBLE UNIT
2.
As a reasonable accommodation for a family 
  
member with disabilities or for a family member with disabilities to find an accessible unit.
 
Entity ID: 
HOH Name: 
Telephone Number: 
Email Address: 
 
Please select below the reason for your request for a voucher extension. 
 
EXTENUATING CIRCUMSTANCE
  
 
       Briefly explain nature of circumstance: _______________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
 
REASONABLE ACCOMODATION FOR AN ACCESSIBLE UNIT
  
 
       Briefly detail accessibility requirements: ______________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
__________________________________________________________________________________________________ 
 
Signature: ________________________________________ 
 
Date: _____________________________ 
FOR MDHCVP USE ONLY 
 
Original Issue Date: _______________________   
Original Expiration Date: _____________________________ 
Is this the first Extension Request? 
 Yes 
 No  
If No selected, provide the first voucher extension issue date: _______________  Expiration Date: ___________________ 
New Issue Date: ____________________________ 
 
New Expiration Date: ____________________________ 
 
Check below if applicable: 
 
FINAL VOUCHER EXTENSION
 
 
Approved By: ________________________________________   
Date: __________________________________ 
MDC‐0054 Request for Voucher Extension 
 
 
 
Rev. 11/2014