Applicant Status

The following questions pertain to specific eligibility requirements of the Housing Credit Program.

1. Are you or any other adult household members claiming zero income?
YesNo

2. Are you or any other household members currently a full-time student or expect to be a full-time student within the next 12 months?
YesNo

3. Will you or any adult household member require a live-in care attendant to live independently?
YesNo

4. Will your household be receiving Section 8 rental assistance at the time of move-in?
YesNo

5. Will your household be eligible or are you applying to receive Section 8 rental assistance in the next 12 months?
YesNo

6. Have you, or anyone else named on this application been convicted of a felony?
YesNo

7. Have you, or anyone else named on this application been evicted from a rental unit of any type including an apartment, home, mobile home, or trailer?
yesno

Residence History

 
List the past 10 years of housing references.

Housing Reference 1

Previous Address

Street Address

City

State

Zip

Move-In Date

Move-Out Date

Rent Paid

Reason for Leaving

Landlord’s Name

Landlord’s Phone

Landlord's Address

Street Address

City

State

Zip

Housing Reference 2

Previous Address

Street Address

City

State

Zip

Move-In Date

Move-Out Date

Rent Paid

Reason for Leaving

Landlord’s Name

Landlord’s Phone

Landlord's Address

Street Address

City

State

Zip

Housing Reference 3

Previous Address

Street Address

City

State

Zip

Move-In Date

Move-Out Date

Rent Paid

Reason for Leaving

Landlord’s Name

Landlord’s Phone

Landlord's Address

Street Address

City

State

Zip

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