HUD 52517-Cambodia Request for Tenancy Approval Housing Choice Voucher Prog

Bak´ es~i’sUmkarGnujatiCYlpæH

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

Request for Tenancy Approval

OMB Approval No. 2577-0169

Housing Choice Voucher Program

(exp. 09/30/2010)

esck¶iraykarN_ GMBi kar¨bmUl yk Bt_man eday mansMnYr V"n'sµan k~¬gkareqÂiy tb 08/ema"g k~gcMeLiy nimUy @ rab'TaMg eBl Binit´emil
esk¶IENnaM, eBl¨bmUlyk ¨bPB Tin~n&y ehiy nwg rk§aTuk Tn~n&ysMxan'@

ehiy nwg ¨bm"UlykB_man. TiP~ak'gar rbs'eyig minVnÓbfm

karsYrsMnYrenaH eT . ehiynak'eqÂiy manesriPaB nwg eqÂiy ò mineqÂiy luH¨ta Et Bt_manTMagenaH ¨tUvTTUl sðal'eday ,manelx rbs'åksYg. OMB
åKYsarCab’eQµaH Gacdak'Bak´ eTAkan’Ggðkar Public Housing Authority (PHA) ebikalNaelaknak’ dak' Bak´ sUmCYlpæH åsbtam kmµviFI

Section 8 of the U.S. Housing Act of l937 (42 U.S.C. 1437f). Ggðkar PHA eåbiBt_manTMagenaH edimºi BicarNaeti åKYsarenaH GacCYlpæHenaH VneT

ebipæHenaH TMen ehiyebikarCYlpæHenaHåsbtam escki¶dMrUv rbs’ kmµviFICYlpæH .,kareqiÂy nwg sMnYr CakardMrUv edimºiTTUlykåbeyaCn_Bi

rdaPiVl shB&nì .. . Bt_manTagenaH min Gac Tuk CakarsMg"at’VneLiy ..
1. eQµaH (PHA)

2. Gas&ydìan

3. «f©Ex en karcab'ep¶imdakBak´

4.

sUmCYl

cMnUnbnæb'edk

5. Year q~aMsg'

6. d«m CUl

7. luykk' .

8.ef© Edl pæHTMen

edimºieFÃiGFikarkicÍ

åbePTpæH / GaV”tm”g’

9.

pæHsMrab’åKYsar mYyDetached / pæHCYr

pæHGarden / Walkup

Gasg’s&r/ High-Rise

10. ebikalNa pæHenaH rdìCYy sUm bJØak' ¨bePT
Ep~k 202
eKhdìan

Ep~k 221(d)(3)(BMIR)

Ep~k 236 (bg'¨bak'Fana É eT ?)

Section 515 karGPivDón_CnbT

tak'Bnëda

ep§g @ (sUm ra"yra"b' )_________________________________________________________________________________
11. TwkePÂig nwg m"asuine¨bi¨Vs'

mÍas'pæH ¨tUvp¶l' É bg'luyCMnYs «fÂePÂig nwg Twk ehiy nwg masIne¨bi¨basbJØak' xageåkam Gk§r “O”. nak'CYlåtUv bg'efTwk ePÂig nwg masuine¨bi¨Vs'tam
Gk§ “T”.ebikalNa KµankarpÂas'b¶èreT ..
¨bkar

bJØak'¨bePTe¨bg

p¶l'[BI

kMedA

Ósµ&nFmµCati

Ósµ&nFug

e¨bg

GKðisniI

F´èg ò d«T

cMGinGahar

Ósµ&nFmµCati

Ósµ&nFug

e¨bg

GKðisniI

F´èg ò d«T

FugTwkek¶A

Ósµ&nFmµCati

Ósµ&nFug

e¨bg

GKðisniI

F´èg ò d«T

ecjluyBI

GKûisniy É d«T
Twk
lU Twksí¬y

kareVHBum¸p§Bp§ayBielIkmunVn¨tUvTukCaemaX:

TMB&r 1 of 2

form HUD-52517-Cambodian (06/2003)
ref. Handbook 7420.8

yksMramecal
ma"suinåtCak'
TUrTwkkk
c¨gûan / ma¨kUevv
d«T sUmbJØak'

12.
a.

kicÍsn´a rbs’m©as’pæH

kmµviFi dMrUv [ Ggkar PHA bJØk’ fa dem CYlpæH

minåtUvelisBi dEm CYl[nak’dET EdlminVncUlrYmk~ug

kmµviFiCYlpæH .mÍas’pæH elis Bi 4 pæH åtUvbMeBj Ep~kxageåkamenH
EdleTibnwg CYl [nak’dET.

Gas&ydìan nwg elxpæH

«f©CYl

c sUmKUs

d«mÂ

_______
1.

åtUvåVb'

fa

man

Cati

sMNr

enAku~¬g

labeT.minrab’pæHEdlsg’ eåkayBief Ti 1 Ex mkra qaM 1978 .

faM

_______ TIkEnÂgeåkApæH manf~aM lab VnåtUvrkeXijfa minmanFatu

sMNreT eday GFikar Edlmansjab&åt TTYlsðal’eday rdìaPiVl

2.

shB&nì,

______ escki¶EfÂg pØab’CamUy p¶l’Bt_man GMBi f~aMlabBN_

edlGacenaH

3.

[maneåKaHf~ak’

dl’

TI

kenÂgrYm

Bt_manenaH VnåtUvp¶l’edaym©as’pæH [åKYsar ..
13
b.

m©Ías’pæH minEmnCa{Bukm¶ay , minEmnkUn,ecA, bgbèín É

enAe¨kApæH

.

PHAmi
minVn Binit´ emil Giriyabf rbs’ åKYsar òsm nwg Gnujati
[ CYlpæHeT . enH Ca muxnaTi rbs’ mÍaspæH ..
.

sac’jati lðikNa Et Ggðkar PHA bJØak’

14. kicÍsn´a CYlpæH åtUv rab’ ma¨taTagGs’ rbs’ Ggðkar The HUD

minKitGMBier¯g åKYsareT ehiy Gac sMrYl[smaCikåK¬èsarNa Edl

tenancy addendum.
15. PHA nwgerobcM [ manGFikarkic©mÍas’pæH nwg åKYsar eTaHCa VnåtUv

ehiyVnsresråbab'b’©as’pæH fa karyl’åBm[CYlpæH
Bikar.

Gnujati k_eday

sumsrsereQµaHmÍas’pæH / dMNag mØas’pæH

sresrQµaHm©as’pæH

ht¶elxa

hat¶elxa emåKYsar

Gas&ydían

Gas&ydíanrbs’åKYsar

TUrs&BÃ

«f© Ex

TUrs&BÃ

«f© Ex

äksarenH Ca esck¶IbkE¨b rbs' äksar¨sbcºab'rbs'Ggðkar HUD Edl Vn¨tUvp§Bp§ay. Ggðkar HUD p¶l' karbkE¨b dl' Gs'elak G~k, Edl Ca karsmrm´ gay¨sYlnwgCYyelak G~k [ yl'dwg GMBIsiTìirbs'elak G~k
nwgkatBÃkicÍ . äksarCaPasaGg'eKÂ enH mansPaBtampÂèvkar ¨sbcºab' nwg mansuBlPaB . äksar bkE¨bPasa minEmn äksar tampÂèvkareT .

kareVHBum¸p§Bp§ayBielIkmunVn¨tUvTukCaemaX:

TMB&r 2 of 2

form HUD-52517-Cambodian (06/2003)
ref. Handbook 7420.8