Income is counted for anyone 18 or older. If the income is unearned, such as a grant of benefit, it is still counted for all household members including minors. Include all income anticipated for the next 12 months.
- Apartment Application
- Step 2
- Step 3
- Step 4
For which location are you applying?
Date of Birth
Home Telephone Number
Work or Cell Number
Type of apartment desired - Ex: One Bedroom
Please list all household members that are applying to live in this apartment.
Household Member One
Household Member One First Name
Household Member One Middle Name
Household Member One Last Name
Household Member One Relationship to Head of Household
Household Member One Date of Birth
Household Member One Gender
Household Member One Full-time Student
Household Member Two
Household Member Two First Name
Household Member Two Middle Name
Household Member Two Last Name
Household Member Two Relationship to Head of Household
Household Member Two Date of Birth
Household Member Two Gender
Household Member Two Full-time Student
Will there be any other household members?
Current Street Address
Have you ever used another name?
Do you expect any change in the number of students in your household within the next 12 months?
Do you expect any additions to the household within the next twelve months?
Do you, or anyone in your household receive, or expect to receive income from:
Employment wages or salaries? - List Annual Income and Income Source (Include overtime, tips, bonuses, commissions and payments received as cash.)
Self-employment? - List Annual Income and Type of Business (Include overtime, tips, bonuses, commissions and payments received as cash.)
Unemployment benefits or worker’s compensation? Contact Person at Agency and Number as well as Amount Received
Public Assistance, General Relief or Aid to Families with Dependent Children? Contact Person at Agency and Number as well as Amount Received
Child support or Alimony? - Payor Name and Amount Received (We must count court-ordered support whether or not it is received unless legal action has been taken to remedy. We must also count support that is not court-ordered but received directly from the payor.)
If receiving Child Support or Alimony, How is the support received?
If receiving Child Support or Alimony, List name of Agency, Court or Individual and Phone Number
If receiving Child Support or Alimony and money is not actually received, are you taking legal action to remedy? Please explain:
Social Security, SSI or any other payment from Social Security Administration? Please list Office Location and Amount Received.
Regular payments from Veteran’s, Pension, or Retirement Benefits or Annuities? Please list source of Pension/Benefit and Amount Received.
Regular payments from a Severance Package? Please list Company Name and Amount. Received.
Regular payments from any type of settlement? - (For example, insurance settlements.) Please list Source of Benefit and Amount Received.
Regular gifts or payments from anyone outside of the household? (This includes anyone supplementing your income or paying any of your bills.) Please list Name of Source of Benefit and Amount Received.
Educational grants, scholarships, or other student benefits? Please Name the Source of Benefit and Amount Received.
Regular payments from lottery winnings or inheritances? Please Name the Source of Benefit and Amount Received.
Regular payments from rental property or other real estate transactions? Please list the Address of Real Estate and Amount Received.
Any other income sources or types not listed? Please Name the Source of Benefit and Amount Received.
Do you or any other household member(s) expect any changes to your income in the next 12 months?
Please explain if you answered yes to the previous question
Please include all assets held and the income derived from the asset. Include all assets held by all household members including minors. Do you or anyone in your household hold:
A checking or savings account?
CD’s, money market accounts, or treasury bills?
Stocks, bonds, or securities?
IRA’s, Keogh, or other retirement accounts?
Cash on hand over $500?
Real estate, rental property, land contracts/contract for deeds or other real estate holdings?
Personal property held as an investment?
Whole Life Insurance Policies?
Have you or any other household members disposed of or given away and asset(s) for less than fair market value within the past 2 years?
The following questions pertain to specific eligibility requirements of the Housing Credit Program.
Are you or any other adult household members claiming zero income?
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?
Will you or any adult household member require a live-in care attendant to live independently?
Will your household be receiving Section 8 rental assistance at the time of move-in?
Will your household be eligible or are you applying to receive Section 8 rental assistance in the next 12 months?
Have you, or anyone else named on this application been convicted of a felony?
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?
List the past 10 years of housing references. Housing Reference One Previous Address
Housing Reference One Street Address
Housing Reference One City
Housing Reference One State
Housing Reference One Zip
Housing Reference One Move-In Date
Housing Reference One Move-Out Date
Housing Reference One Rent Paid
Housing Reference One Reason for Leaving
Housing Reference One Landlord’s Name
Housing Reference One Landlord’s Phone
Housing Reference One Landlord's Street Address
Housing Reference One Landlord's City, State, Zip
Housing Reference Two Previous Address
Housing Reference Two Street Address
Housing Reference Two City
Housing Reference Two State
Housing Reference Two Zip
Housing Reference Two Move-In Date
Housing Reference Two Move-Out Date
Housing Reference Two Rent Paid
Housing Reference Two Reason for Leaving
Housing Reference Two Landlord’s Name
Housing Reference Two Landlord’s Phone
Housing Reference Two Landlord's Street Address
Housing Reference Two Landlord's City, State, Zip
Housing Reference Three Previous Address
Housing Reference Three Street Address
Housing Reference Three City
Housing Reference Three State
Housing Reference Three Zip
Housing Reference Three Move-In Date
Housing Reference Three Move-Out Date
Housing Reference Three Rent Paid
Housing Reference Three Reason for Leaving
Housing Reference Three Landlord’s Name
Housing Reference Three Landlord’s Phone
Housing Reference Three Landlord's Street Address
Housing Reference Three Landlord's City, State, Zip
Please list the information for any vehicles owned or operated by any household member. Vehicle One
Vehicle One Member Name
Vehicle One Driver’s License
Vehicle One Vehicle Make
Vehicle One Vehicle Model
Vehicle One Vehicle Year
Vehicle One Vehicle License
Vehicle One State in Which Vehicle Licensed
Vehicle Two Member Name
Vehicle Two Driver’s License
Vehicle Two Vehicle Make
Vehicle Two Vehicle Model
Vehicle Two Vehicle Year
Vehicle Two Vehicle License
Vehicle Two State in Which Vehicle Licensed
Who should be notified in case of an emergency?
Emergency Notification First Name
Emergency Notification Last Name
Emergency Notification Relationship
Emergency Notification Phone
Emergency Notification Street Address
Emergency Notification City
Emergency Notification State
Emergency Notification Zip
Does anyone in your household have special needs?
A PLACE TO CALL HOME
Panorama Apartments111 Brent Spence Sq, Main Office
Covington, KY 41011
Panorama Plus8510 Old Toll Rd
Florence, KY 41042