Preliminary Housing Application Template - 2013
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2PRINCETON COMMUNITY HOUSING
Providing, managing and advocating for affordable housing
Application ______
GRIGGS FARM
One Monument Drive
Princeton, NJ 08540
609-924-3822 fax 609-924-3827
TTY 1-800-852-7899
Preliminary Housing Application
Name: ______________________________________________________________________
Address: ___________________________________________________________________
City: ________________________________State:___________________Zip:____________
Home Phone :__________________(cell) _____________________(work) ____________________
Email address: _________________________________________________________________
Name of all household members
Relationship to
who plan to live w/you
head of
Sex
Social Security
(include self)
household
Birthdate
(M/F)
Number
HEAD
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Employers/Income for all household members:
Household Member Name
Employer
Gross Annual Income
How Long Employed?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Total Household Annual Income: $__________________________
Dollar value of all assets (checking/savings/money market accounts, stocks/bonds, real estate, etc.):
$_______________________________Type of Account____________________
$_______________________________Type of Account____________________
$_______________________________Type of Account____________________
$_______________________________Type of Account____________________
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