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Northern Circle Indian Housing Authority
(707) 468-1336
FAX (707) 468-5615
694 Pinoleville Dr. Ukiah 95482
5280 Lower Wyandotte Rd Oroville 95966
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Income Verification Form
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Maintenance Request Form
Please submit your maintenance issues in the following form. Include as much detail as possible, and attach relevant photos. We will contact you within one business day (Mon-Fri) of your submission.
Please Note:
this form is for tenants of Northern Circle rental units.
Home owners should apply for
assistance from our Home Rehabilitation program.
Emergency
Check here ONLY if this is an emergency situation such as a broken pipe with running water, leaking gas/propane, exposed electrical, or something else which creates an immediate threat to the home or the health and safety of your family.
If you are reporting an emergency issue, you can also call Josh Pike at 707-472-6121
.
Emergency
Resident's Name
(Required)
Address
(Required)
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
(Required)
Email
Tribal Affiliation
(Required)
Tribal Affiliation
Berry Creek Rancheria of Maidu Indians
Guidiville Rancheria
Hopland Band of Pomo Indians
Manchester/Point Arena Band of Pomo Indians
Mooretown Rancheria of Maidu Indians
Redwood Valley Little River Band of Pomo Indians
Sherwood Valley Rancheria of Pomo Indians
Type of Problem
Type of Problem
Electrical (outlets, light switches or fixtures, circuit breakers, etc)
Plumbing (sinks, toilets, tub/shower, faucets, garbage disposal, etc)
Heating or Air Conditioning
Floors or Flooring
Water Heater
Walls or Sheetrock
Roof (leaks during rain)
Exterior (sidewalks, steps, siding, etc)
Fence or Gate
Applicance
Description of Problem
File
Drop files here or
Select files
Accepted file types: jpg, gif, png, heic, pdf, Max. file size: 128 MB.