Rental Application Instructions

RENTAL APPLICATION INSTRUCTIONS

Thank you for taking the time to visit our apartment community. We hope we can call you “Neighbor” soon! We trust that the instructions listed below will help you complete your application in an easier more efficient manner. If you have any questions or require further assistance in completing this application please do not hesitate to ask for our assistance.

IF YOU ARE DISABLED OR HAVE DIFFICULTY COMPLETING THIS APPLICATION, PLEASE ADVISE US OF YOUR NEEDS NOW OR CALL US TO SCHEDULE ASSISTANCE.

APPROPRIATE ASSISTANCE WILL BE PROVIDED IN A

CONFIDENTIAL MANNER AND SETTING.

• Please answer all questions including “N/A” for questions that are not applicable.

• All adult household members must present a Drivers License or Picture I.D. and proof of Social Security number or explanation for not having a Social Security number.

• Completed applications will be placed on our Waiting List. Applicants will be notified in writing at the address they have provided. Management will contact you as your name nears the top of the Waiting List. An appointment will be set at your convenience to complete the final phase of the application process, at which time final eligibility for housing and program compliance will be determined.

• Applications placed on the Waiting List will automatically expire in six months. To remain on the Waiting List you must contact our office at least every six months so that we can review and update the application. If any of the household information listed on this application changes before the six-month time frame has expired, it is the applicants’ responsibility to notify Management in person, by telephone or in writing immediately. We must be able to contact you regarding your Waiting List status and eligibility.

504 NON-DISCRIMINATION NOTICE

If you have a visual, hearing or physical impairment and need assistance with this “Notice”, our personnel will provide or arrange for appropriate assistance.

To schedule assistance, please call the apartment community office weekdays between the hours of 8:00 a.m. and 5:00 p.m. at ______. This line is not equipped for the hearing impaired. Therefore, please call the numbers below, if applicable:

New Mexico RELAY: (TTY) 1-800-659-8331 (voice) 1-800-659-1779 or “711”

Texas RELAY: (TTY) 1-800-735-2989 (voice) 1-800-735-2988 or “711”

This assistance is provided to insure equal access in a confidential manner and setting.

IN ACCORDANCE WITH SECTION 504 of the Rehabilitation Act of 1973, ______Apartments, hereby notifies the general public that:

1. No qualified individual with a disability shall, solely on the basis of disability, be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination under any Federally assisted program or activity administered by this housing community.

1. We will provide employment opportunities, benefits, access to housing and other appropriate services in a manner that will not, directly or through contractual or other arrangement, subject qualified individuals with a disability to discrimination solely on the basis of disability; and,

1. We will not participate in any contractual or other relationship that has the effect of subjecting a qualified individual with a disability to discrimination solely on the basis of disability.

It is the intention of Management to take reasonable, affirmative steps to increase access and opportunities for disabled individuals in all programs, services, and administrative operations.

We have designated Jack MacGillivray to serve as the 504 Coordinator. He can be reached by calling 505-260-4800.

• I/We have read and understand the 504 Non-Discrimination Notice. All adults must initial on the line provided. Please Initial: ______

OPTIONS FOR APPLICANTS WITH DISABILITIES

We provide affordable housing to applicants that qualify for Federal rental assistance programs and meet all conditions of our “Resident Selection Plan”. The “Plan” is located is the apartment community office for your reference. We are not permitted to discriminate against applicants on the basis of their race, color, sex, national origin, familial status, or disability. In addition, we have a legal obligation to provide “Reasonable Accommodations” to applicants if they or any household members have a disability. Compliance actions may include reasonable accommodations as well as structural modifications to the unit or premises.

A reasonable accommodation is some modification or change that can be made to the policies or procedures that will assist an otherwise eligible applicant with a disability to take advantage of the program. Examples of reasonable accommodations and structural modifications include:

• Making alterations to a unit so it could be used by a household with a wheel chair;

• Installing strobe light smoke detectors in an apartment for a household with a hearing impaired member;

• Permitting a household to have a seeing eye dog to assist a vision impaired household member in a community where dogs are not usually permitted;

• Make a sign language interpreter available to a hearing impaired applicant during the interview; or

• Permitting an outside agency to assist an applicant with a disability to meet the property’s screening criteria.

An applicant household that has a member with a disability must still be able to meet essential obligations of tenancy. They must be able and willing to pay rent, to care for their apartment, to report required information to Management, avoid disturbing their neighbors, etc. However, there is no requirement that they be able to do these things without assistance.

• I/We have read and understand the Options for Applicants with Disabilities. All adults must initial on the line provided.

Please Initial: ______

REASONABLE ACCOMMODATION

If you or a member of your household has a disability and you believe you might need or want a reasonable accommodation, you may request it at any time during the application process or after admission to the property. This is up to you. If you prefer not to discuss your situation with Management, that is your right. Please check one below:

Yes, I wish to request reasonable accommodation. (Manager: complete Forms RS-9 and RS-10)

No, reasonable accommodations are not needed.

I wish not to discuss the situation with Management. Please Initial: ______

INFORMATION FOR ADULT STUDENTS

If you and/or any adult member of your household applying for an apartment is or will be a full-time or part-time student you and/or they will be required to complete additional form(s) and supply the required documentation. Please check one below and initial where indicated as applicable to the household:
Yes, there is/are ____ full-time or ____part-time student(s) in the household. (Manager: complete USDA form RS-24r for full-time students only; or, HUD form RS-24h for both full-time and part-time students. Complete one form for each student in the household as relevant.)
No, adult (age 18 or older) in the household is a full-time or part-time student.
Please Initial: ______

EMERGENCY CONTACT(S)

Name: Telephone: Relationship:
Address: / City: / State: / Zip Code:
Name: Telephone: Relationship:
Address: / City: / State: / Zip Code:

In the event that I/we cannot be reached directly the above named person(s) _____May _____ May Not be contacted regarding the status of my/our application. Please initial______

Application For Residency (9/08)Page 1 of 6RS-1hr

APPLICATION FOR RESIDENCY

FOR MANAGEMENT’S USE ONLY

Application:

Date: ____/____/____Time: ______Waiting List Priority Code: ______

(Must match Waiting List at all times)

Date Renewed: ____/____/____Accessible Unit Desired? ______

Date Renewed: ____/____/____Federal Preference Verification Received? ______

Program Type: Bedroom Size: (check one) Studio 1 2 3 4

NOTICE TO APPLICANT

Please complete this application and return it to the Management Office. Applications are placed in order of the date and time received. Applicant(s) may be interviewed only after the Management Office receives this application completed in full. This application automatically expires after six (6) months unless you contact the apartment community office in person, by telephone or in writing to renew.

GENERAL INFORMATION

Applicant Name(s):
Address(es): / City: / State: / Zip:
Telephone Number: (Cell) / (Home) / (Work)
Bedroom Size Requested: (check one) Studio 1 2 3 4
Does your household have a pet(s)? Yes No If yes, number and type:
How did you hear about us? Advertisement Friend/Family Other:______

Household COMPOSITION

Please list yourself and all household members who will reside with you.
Also include those who are temporarily absent:
NAME(S) / RELATION TO HEAD OF HOUSE / AGE /

SEX

/ DATE OF BIRTH / OCCUPATION OR SCHOOL NAME (IF STUDENT) / SOCIAL SECURITY NUMBER
Head ofHouse
List all sources of income for ALL household members below:
Household Member Name / Type of Income / Monthly
Amount / Source
Employment / $
Employment / $
Employment / $
Social Security / $
Social Security / $
SSI Benefits / $
SSI Benefits / $
Self-Employment / $
List all sources of income for ALL household members below: (continued)
Household Member Name / Type of Income / Monthly
Amount / Source
Self-Employment / $
Veterans/Pension Benefit / $
Veterans/Pension Benefit / $
Student Grants, Scholarships, etc. / $
Student Grants, Scholarships, etc. / $
Unemployment / $
Unemployment / $
TANF/General Assistance / $
Child/Family or Alimony Support / $
Other Sources including Cash / $
Do you anticipate any changes in this income in the next 12 months? / Yes No
If YES please list:

ASSETS

List for ALL household members including children and those owned jointly with another person(s):

Type of Account

/

Account Number

/

Source Name

/

Value

Checking and Savings Account(s): / # / Bank/Institution: / $
# / Bank/Institution: / $
Retirement (IRA, KEOGH, etc.) Account(s): / # / Bank/Institution: / $
# / Bank/Institution: / $
Inheritances, Trust Account(s): Include Burial Accounts / # / Bank/Institution: / $
# / Bank/Institution: / $
Certificates of Deposit, Money Market(s): / # / Bank/Institution: / $
# / Bank/Institution: / $
Credit Union(s): / # / Bank/Institution: / $
# / Bank/Institution: / $
Stocks and Bonds: / # / Maturity Date: / $
# / Maturity Date: / $
“Whole” Life Insurance Policies: / # / Face/Cash Value: / $
# / Face/Cash Value: / $
1. Do you own any land/buildings/real estate? Yes No / If YES, type of property:
Location:
Full market value on most recent tax bill? / $ / Mortgage or outstanding loan(s) balance owed? / $
Amount of annual insurance premium? / $ / Taxes on most recent tax bill? / $
2. Have you or any household members’ sold/disposed of any land or buildings in the last two years? Yes No
If YES, type of property? / Market value when sold/disposed? / $
Date of disposition? / Amount sold/disposed for? / $
3. Have you disposed of any other assets in the last two years? (Example: gave
away money to relatives, set up irrevocable trusts accounts.) Yes No / Date of disposition?
If YES, describe asset: / Amount disposed? / $
4. Do you have any other assets not listed above (excluding personal property)? Yes No
If YES, list: / $ / $

ALLOWABLE EXPENSES

Complete the medical sections ONLY if Head of Household, Co-Head or Spouse is age 62 or older or disabled. If this applies to your household, include amounts for ALL household members after agency or insurance payments:

Monthly Amount / Monthly Amount
Medicare Premiums: / $ / Medicines: / $
Physicians/Dentists, other: / $ / Health Insurance Premiums: / $
Other Allowable Expenses:
Childcare Expense: (for children UNDER 13 years of age to allow an adult to work, look for work,
or go to school.) / $
Disability Assistance Expense: (Retrofitting a vehicle, attendant care, auxiliary aid, etc.) / $

RESIDENTIAL HISTORY

Are you currently receiving government rental assistance (HUD, USDA, Public Housing, etc.) at your current place of residence? ___ Yes ___ No. If yes, please provide the housing provider name, address and telephone number below.

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Please provide TWO (2) years of housing history starting with your most current address. All dates must be consecutive, without any lapses in time.

Dates of Residency: From (m/d/y) _____ /______/______
To (m/d/y) / / / Do you have an executed lease agreement at this address? Yes No
Current
Address: / City: / State: / Zip
Code:
Housing Provider’s
Name: / Telephone:
Address: / City: / State: / Zip
Code:

PREVIOUS RESIDENCY INFORMATION

Dates of Residency: From (m/d/y) / / To / /
Prior
Address: / City: / State: / Zip
Code:
Housing Provider’s
Name: / Telephone:
Address: / City: / State: / Zip
Code:
Dates of Residency: From (m/d/y) / / To / /
Prior
Address: / City: / State: / Zip
Code:
Housing Provider’s
Name: / Telephone:
Address: / City: / State: / Zip
Code:

If these addresses do not cover a two-year history, please add additional addresses and contact information on the last page of this “Application for Residency”.

1. Have you or any household member ever been evicted or otherwise removed from rental housing? Yes No
If YES, explain circumstances, outcome and present status:
2. Have you or any household member ever engaged in drug-related criminal activity, such as use,
possession, distribution, trafficking, or manufacture of an illegal drug? Yes No
If YES, explain circumstances, outcome and present status:
3. Have you or any household member ever engaged in, been arrested, and/or convicted of any other
criminal activity? Yes No
If YES, explain circumstances, outcome and present status:
4. Are you or any household member currently serving in any branch of the armed services? Yes No
If YES, what branch?
5. Is your household currently displaced due to a Federally declared disaster? Yes No
If YES, provide verification:

CERTIFICATION BY ALL ADULT HOUSEHOLD MEMBERS

I/We have read, and understand, the information in this application in particular the information contained in the instructions and I/we agree to comply with such information.

I/We have been notified that the “Resident Selection Plan”, which summarizes the procedures for processing applications, is available in the apartment community’s Management Office; and that my/our application will be processed according to the “Resident Selection Plan”.

I/We understand that by completing this application, my/our name(s) will be placed on a Waiting List, but this does not guarantee that my/our household will be offered an apartment. If later processing establishes that my/our household is not actually eligible, or does not meet Management screening criteria, I/we understand that this application will be rejected and that I/we will be notified in writing.

I/We authorize the Management to make any and all inquiries to verify this application information either directly or through information exchanged now or later with rental, police and credit screening services, and to contact previous and current housing providers or other sources for credit and verification confirmation which may be released to appropriate Federal, state, or local agencies. I/We authorize Management to obtain one or more “consumer reports” as defined in the Fair Credit Reporting Act, 15 U.S.C. Section 1681a(d), seeking information on my/our credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, and/or mode of living.

I/We understand that I/we may request sample copies of the Rental Agreement and Management Rules. If this application is approved, and move-in occurs, I/we certify that I/we will accept and comply with all conditions of occupancy as set forth therein, including specifically all conditions regarding pets, rent damages, and Security Deposits.

If my/our application is approved and move-in occurs, I/we certify that only those persons listed in this application will occupy the apartment, that they will maintain no other place of residence, and that there are no other persons for whom I/we have or expect to have, responsibility to provide housing.

I/We understand that I/we will need to complete an attachment for all household members that consists of a Declaration of U.S. Citizenship and/or Immigration Status at a date and time specified by Management so that final eligibility for housing may be determined.

I/We also understand that this application will expire automatically after six (6) months unless I/we contact the office in person, in writing or by telephone to renew.

I/We certify that all information given in this application and any addenda thereto is true, complete and accurate. I/We understand that if any of this information is false, misleading or incomplete, Management may decline my/our application or, if move-in has occurred, terminate my/our Rental Agreement.

SIGNATURES

Applicant’s Signature: / Date:
Co-Applicant’s Signature: / Date:
Co-Applicant’s Signature: / Date:
Other Household Member’s, 18 years or older, Signature: / Date:
Other Household Member’s, 18 years or older, Signature: / Date:

Warning: Section 1001 of Title 18 of the United States Code provides: “Whoever, in any matter within any jurisdiction of any department or agency of the United States knowingly or willfully falsified, conceals or covers up…a material fact, or makes any false, fictitious or fraudulent statements or representation, or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than 5 years or both.

RACE AND ETHNICITY OF HEAD OF HOUSEHOLD

The information regarding race, national origin, and sex designation solicited on this application is requested in order to assure the Federal Government, acting through the Rural Housing Development/HUD/Tax Credit Agency, that the Federal Laws prohibiting discrimination against tenant applicants on the basis of race, color, national origin, religion, sex, familial status, age and disability are complied with. You are not required to furnish this information, but are encouraged to do so. Your response is optional. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the Owner is required to note the race/national origin and sex of individual applicants on the basis of visual observation or surname. Please complete BOTH race and ethnicity sections.

Race of Household Head:
Please check one or more
of the following: / White / Other
Black or African American / Asian/Pacific Islander
Native American/Alaskan/Hawaiian
Ethnicity of Household Head: Please check one: / Hispanic or Latino
Not-Hispanic or Latino

For HUD sites only: Please complete the attached “Race and Ethnicity” form HUD-27061-H (a.k.a. TC-52)

Application For Residency (9/08)Page 1 of 6RS-1hr