Housing Application Form
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Office Use Only)
Time:
Date:
WL#:
AMI%
Annual
#BR:
$
This is a Pre-Application for the
Washington Court- 100 Washington Street, Red Bluff, CA. 96080
Please submit this to the rental office at the property in which you would like to apply.
Rural Communities Housing Development Corporation does not accept rental applications at
our main office.
Thank you for your interest in our apartment communities. Please answer the following questions
completely and honestly to the best of your abilities. Incomplete pre-applications cannot be accepted.
Should you make a mistake, please draw a line through the mistake, make the change, and then initial it or
fill out a new pre-application. Do not use white out. This pre-application is only to be used to reserve a
place on the waiting list for the property in which you wish to apply and does not determine your
eligibility for the property. A more thorough determination of eligibility will be made once your name
comes to the top of the waiting list and a unit is scheduled to be vacated. Each property operates
separately, and as such, a separate application must be completed for each property.
How did you hear about us?
Part I. Household Composition
1. Name of Head of Household
2. Home Phone Number
3. Alternate Phone Number
4. Current Physical Address
5. Mailing Address, if different than above
6. Current Landlord Contact Information
7. Previous Landlord Contact Information, if less than 2 years at the current location
Page 1 of 4
Form 540 Rev 2/14
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