Residency Pre-Application Page 2
ADVERTISEMENT
1
2
3SOURCES OF INCOME (All Household Members 18 years of age and older)
THIS INCLUDES, BUT IS NOT LIMITED TO, FULL AND/OR PART-TIME EMPLOYMENT, WELFARE ASSISTANCE, SOCIAL SECURITY, PENSIONS, SSI,
DISABILITY, MILITARY PAY/BENEFITS, UNEMPLOYMENT, CHILD SUPPORT, ALIMONY, STUDENT GRANTS/LOANS, SELF-EMPLOYMENT, LOTTERY
INCOME, INCOME FROM THE SALE OF PROPERTY, INCOME FROM TRUSTS AND ANY OTHER INCOME RECEIVED FROM PEOPLE NOT RESIDING
WITH YOU.
EMPLOYER NAME
ANNUAL GROSS INCOME
DATES OF EMPLOYMENT
$
OTHER INCOME SOURCE
GROSS ANNUAL AMOUNT
$
OTHER INCOME SOURCE
GROSS ANNUAL AMOUNT
$
OTHER INCOME SOURCE
GROSS ANNUAL AMOUNT
$
ASSET INFORMATION (Bank, Retirement, Real Estate, Checking, Savings, CDs, Stocks)
FINANCIAL INSTITUTION
CURRENT BALANCE
$
FINANCIAL INSTITUTION
CURRENT BALANCE
$
MARKET SOURCE
____ Property Website ____ Current Resident Referral ____ Housing Authority Referral
____ Banners/Signs/Flyers ____ Drive by ____ Social Media ____ Apt.Finder
ADDITIONAL REQUIRED INFORMATION
Have you ever been evicted?
___Yes
___ No
If yes, when?
___________________________________________
Have you or any person who will be occupying the unit ever been convicted,
___Yes
___No
pled guilty or no-contest to any crime?
Does your household have any pets?
___Yes
___ No
Will your household be eligible or are you applying to receive Section 8 rental
___Yes
___ No
assistance in the next 12 months?
All Household members 18 years of age or older must review this application, read the statement
below and then sign and date the rental application:
I/We understand that it is our responsibility to contact the Office if any of the information provided on
this application changes, including but not limited to, changes in mailing address, phone numbers,
household composition, income or asset information.
Signature:
Date:
Signature:
Date:
Signature:
Date:
Signature:
Date:
If upon preliminary review, your application appears to be eligible based upon the information you have
provided, you will be placed on the waiting list. This does not indicate that you will be offered an
apartment. When we expect an apartment to be available in the near future, we will process your
application in accordance with the Resident Selection Criteria. If this establishes that your household is
not eligible or not qualified, you application will be denied.
We do business in Accordance with the Federal Fair Housing Law. We will not discriminate against any
person because of race, color, religion, sex, handicap, familial status or national origin, (The Fair
Housing Amendment Act of 1988). In compliance with Section 504 regulations, we do not discriminate
on the basis of handicapped status in the admission or access to, or treatment, or employment in, our
federally assisted programs and activities. Management will consider requests from individuals with
disabling conditions or mobility impairments for reasonable accommodations in policies, practices or
facilities.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business