WAITLIST APPLICATION CHECK LIST

Transcription

1 3550 VILLA LANE NAPA, CALIFORNIA (707) WAITLIST APPLICATION CHECK LIST Thank you for your interest in Silverado Creek rental housing. For your convenience we ve summarized below the items you must bring when you return to complete and submit your waitlist application. To submit a complete application, please return all of the following items: Grounds for Denial, read and signed by all adult household members. Completed and signed WAITLIST APPLICATION by all adult household members Completed and Signed RACE AND ETHINICTY FORM, one per head of household. Thank you for your interest in our community. We appreciate your application and look forward to working with you. EQUAL HOUSING OPPORTUNITY Rev. 08/17/2015

2 SILVERADO CREEK RENTS AND INCOME LIMITS - JANUARY 2016 INCOME LIMITS 2 BEDROOM 1 BEDROOM UNIT SIZE % of Area Median Income Annual MINIMUM INCOME TO QUALIFY (if no rental assistance in place) 1 2 MAXIMUM ANNUAL INCOME FOR YOUR HOUSEHOLD SIZE UNIT RENTS 45% 22, ,540 31,500 35, % 25, ,600 35,000 39, % 23, ,000 31,480 34,960 37, % 26, ,500 35,415 39,330 42, % 29, ,000 39,350 43,700 47, % 26, ,480 34,960 37,760 40,560 43, BEDROOM 45% 30, ,415 39,330 42,480 45,630 48, % 34, ,350 43,700 47,200 50,700 54,200 1,050 55% 37, ,285 48,070 51,920 55,770 59,620 1,163 60% 41, ,220 52,440 56,640 60,840 65,040 1,277 4 BEDROOM 50% 36, ,700 47,200 50,700 54,200 57,700 61,100 1,135

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5 GROUNDS FOR DENIAL OF RENTAL APPLICATION We welcome your application to rent an apartment at Silverado Creek Apartments. It is the responsibility of each applicant to provide any and all information required to determine eligibility. (1) Credit (An exception for extraordinary medical expenses may be permitted.) a) Total unmet credit problems (including governmental tax liens) in excess of 2,500. b) A bankruptcy (within the last three years). c) A total of seven (7) unmet credit problems of any value. (2) Rental History a) A judgment against an applicant obtained by the current or previous landlord. b) An unmet obligation owed to a previous landlord. c) The applicant must have made timely payments of the last year's rental payments. (3) Personal History a) A history of violence or abuse, (physical or verbal), in which the applicant was determined to be the antagonist. b) Current abuse of alcohol or use of illegal drugs. Use shall constitute abuse for illegal drugs (unless required by doctor's verification). (4) Annual Income/Occupancy standard/other program regulations a) Annual Income (including assets) not within the established restrictions for the property. b) Household size must meet the established occupancy standard for the property. c) Applicant must meet all program regulated eligibility requirements. (5) Documentation Each potential occupant must provide all documentation required by the selection process. If an applicant does not show up for an interview, or provide the following documentation, it maybe grounds for denying their application: a) Completed and signed application, release of information, grounds for denial, and application fee (if required). b) Landlord references covering the last five years of residency. Please note: Applicants who have not held a rental agreement for a minimum period of twelve months within the last five years, will be required to provide references from two people not related to the applicant who have known the applicant for at least five years. c) Appropriate proof of all income sources and assets. d) Any other documents required to determine eligibility. (6) Offer of an Apartment Applicants will be offered only one apartment. Declining the offer of an apartment is considered to be a withdrawal of the application by the applicant. I HAVE READ AND UNDERSTOOD THE FOREGOING AND FIND THEM TO BE REASONABLE REASONS MY RENTAL APPLICATION CAN BE DENIED. I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE ATTACHED HOUSING AND INCOME STATEMENTS ARE TRUE AND CORRECT. Applicant # 1 Applicant # 2 Applicant # 3 EQUAL HOUSING OPPORTUNITY 07/29/2009

6 Fill in all blanks. Incomplete applications will not be processed. Lead Applicant Name Mailing Address Street Apt # Co-Applicant City State Zip Home Phone ( ) Work Phone ( ) Where did you hear about us? Contact/Interpreter Name Preferred Apartment Size 1 BR 2 BR 3 BR 4BR Contact/Interpreter Phone ( ) Total Number of People in Household List below all s who will be living in the apartment 1. Name Social Security No. of Birth M/F Relationship to Applicant # Please answer the following questions: Household Size: Do you expect any changes to your household size within the next 12 months?... Yes or No (circle one) Explain: Name, Relationship, etc. Evictions Have you or anyone in your household ever been evicted?... Yes or No (circle one) Explain: Bankruptcy: Have you or anyone in your household ever filed for bankruptcy?... Yes or No (circle one) 1/01 Explain: EQUAL HOUSING OPPORTUNITY 1

7 Custody Do you have full custody of your child(ren) listed above?... Yes or No (circle one) Explanation of custody arrangements: Child Support or Alimony (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 payer) Are you or any one in your household entitled to receive child support or alimony? Yes or No (circle one) If money is not actually received, are you taking legal action to remedy?... Yes or No (circle one) Please provide the name(s) and address(es) of Agency, Court, or Individual providing the support. Name: Address: Special Needs: Do you or anyone in your household have any special housing needs?... Yes or No (circle one) Explain: Live-In Care Attendant: Will you or anyone in your household require a live-in care attendant?... Yes or No (circle one) Section 8 Rental Assistance: Do you possess a current Section 8 voucher or certificate?... Yes or No (circle one) Is it transferable?... Yes or No (circle one) Please provide the name and address of your County or City Housing Authority: Name: Address: Phone: Pets: Do you have a pet?... Yes or No (circle one) If Yes, how many? Full-Time Student Information: (use reverse side if necessary) Description: (This apartment is governed by the Housing Credit Program. This Program has restrictions on full-time students and requires us to determine student status. We must determine this prior to eligibility and, if such eligibility is granted, each subsequent year you remain in the unit.) Are you or any member of your family (including minors) a Full-Time Student?... Yes or No (circle one) Or planning to be a Full-Time Student within the next 12 months?... Yes or No (circle one) If Yes, please list and explain: Name of Student? Name of School? Phone # Address City Zip Personal In case of emergency, please notify: Phone # Relationship EQUAL HOUSING OPPORTUNITY 2

8 Please complete the following income information for every household member: Include all income anticipated for the next twelve (12) months. The following are possible sources of income: (Use additional applicant Income form if necessary) Employment, wages or salaries - include overtime, tips, bonuses, commissions, and payments received in cash Regular gifts or payments from anyone outside of the household - (includes anyone paying your bills) Public Assistance, General Relief or Aid to Families with Dependent Children (AFDC) Regular pay as a member of the Armed Forces Unemployment benefits or workman's compensation Self-employment Stock Dividends Child Support or Alimony Social Security, SSI or any other payments from Social Security Administration Severance Payments Veteran's Benefits, Pensions, retirement Benefits or Annuities Settlements Disability, death benefits or life insurance dividends Lottery Winnings or inheritances Payments from rental properties, land contracts, or other forms of real estate Any other income source not listed Applicant #1 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income Per Year Applicant #2 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Zero Income Verification: Total Income Per Year Are YOU or is ANY other ADULT member of your household claiming zero (0) income? Name Please list: EQUAL HOUSING OPPORTUNITY 3

9 Please complete the following asset information for every household member: Include all assets held and the corresponding annual interest rate, dividends or any other income derived from the asset in the space provided. Include assets that may be held jointly with another. Include ALL assets held by ALL household members including minors (if applicable) An asset is defined as any lump sum amount that you hold and currently have access to. The following are possible sources of assets: (Use additional applicant Asset form if necessary) Checking or savings accounts CD's, money market accounts, or treasury bills Pensions, IRA's, KEOGH or other retirement accounts Real estate, rental property, land contracts for deeds or other real estate holdings Insurance Settlements Stocks, bonds or securities Trust funds Personal property as an investment Any other asset not listed Applicant #1 - Assets Applicant #2 - Assets Have you or any other member of your household disposed of or given away ANY asset(s) for LESS than fair market value within the last two years?... Yes or No (circle one) Amount Explanation EQUAL HOUSING OPPORTUNITY 4

10 Please provide names and addresses of your landlords for the last five years: If you do not have five years of Landlord history, you must provide two (2) al references in their place. (Use reverse side if necessary) Current Residence Address of unit rented City State Zip From To Landlord's name Landlord's phone number ( ) Landlord's complete address City State Zip Landlord's fax number ( ) Previous Residence Address of unit rented City State Zip From To Landlord's name Landlord's phone number ( ) Landlord's complete address City State Zip Landlord's fax number ( ) Previous Residence Address of unit rented City State Zip From To Landlord's name Landlord's phone number ( ) Landlord's complete address City State Zip Landlord's fax number ( ) I certify that the foregoing information is true, complete and correct. I also understand that false statements or omissions are grounds for disqualification, eviction and/or prosecution under the full extent of California law. Inquiries may be made to verify the statements herein. I authorize the release of the requested information to Silverado Creek Apartments for purposes of income verification and credit. Applicant #1 Applicant #2 Applicant #3 Applicant #4 Applicant #5 Applicant #6 Applicant #7 EQUAL HOUSING OPPORTUNITY 5

11 Additional Applicant Income Form Please complete the following income information for every household member: Include all income anticipated for the next twelve (12) months. (Use reverse side if necessary) Applicant #3 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income Per Year Applicant #4 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income Per Year Applicant #5 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income EQUAL Per HOUSING Year OPPORTUNITY 6

12 Additional applicant Assets form Please complete the following asset information for every household member: Include all assets held and the corresponding annual interest rate, dividends or any other income derived from the assets. Include ALL assets held by ALL household members including minors. Applicant #3 - Assets Applicant #4 - Assets Applicant #5 - Assets EQUAL HOUSING OPPORTUNITY 7

13 Additional applicant Income form Use other side if necessary Please complete the following income information for every household member: Include all income anticipated for the next twelve (12) months. (Use reverse side if necessary) Applicant #6 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income Per Year Applicant #7 - Income Name Drivers License/ID # Primary Income Source - Name Contact Person Phone ( ) Additional Income Source - Name Contact Person Phone ( ) Total Income Per Year EQUAL HOUSING OPPORTUNITY 8

14 Additional applicant Assets form Use other side if necessary Please complete the following asset information for every household member: Include all assets held and the corresponding annual interest rate, dividends or any other income derived from the asset in the space. Include ALL assets held by ALL household members including minors. Applicant #6 - Assets Applicant #7 - Assets EQUAL HOUSING OPPORTUNITY 9

15 Race and Ethnic Data U.S. Department of Housing OMB Approval No Reporting Form and Urban Development (Exp. 03/31/2014) Office of Housing Name of Property Project No. Address of Property Name of Owner/Managing Agent Type of Assistance or Program Title: Name of Head of Household Name of Household Member (mm/dd/yyyy): Ethnic Categories* Select One Hispanic or Latino Not-Hispanic or Latino Racial Categories* American Indian or Alaska Native Select All that Apply Asian Black or African American Native Hawaiian or Other Pacific Islander White Other *Definitions of these categories may be found on the reverse side. There is no penalty for s who do not complete the form. Signature Public reporting burden for this collection is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. This information is required to obtain benefits and voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. This information is authorized by the U.S. Housing Act of 1937 as amended, the Housing and Urban Rural Recovery Act of 1983 and Housing and Community Development Technical Amendments of This information is needed to be incompliance with OMB-mandated changes to Ethnicity and Race categories for recording the Data Requirements to HUD. Owners/agents must offer the opportunity to the head and cohead of each household to self certify during the application interview or lease signing. In-place tenants must complete the format as part of their next interim or annual re-certification. This process will allow the owner/agent to collect the needed information on all members of the household. Completed documents should be stapled together for each household and placed in the household s file. Parents or guardians are to complete the self-certification for children under the age of 18. Once system development funds are provide and the appropriate system upgrades have been implemented, owners/agents will be required to report the race and ethnicity data electronically to the TRACS (Tenant Rental Assistance Certification System). This information is considered non-sensitive and does no require any special protection. 1 form HUD H (9/2003)

16 Instructions for the Race and Ethnic Data Reporting (Form HUD H) A. General Instructions: This form is to be completed by individuals wishing to be served (applicants) and those that are currently served (tenants) in housing assisted by the Department of Housing and Urban Development. Owner and agents are required to offer the applicant/tenant the option to complete the form. The form is to be completed at initial application or at lease signing. In-place tenants must also be offered the opportunity to complete the form as part of the next interim or annual recertification. Once the form is completed it need not be completed again unless the head of household or household composition changes. There is no penalty for s who do not complete the form. However, the owner or agent may place a note in the tenant file stating the applicant/tenant refused to complete the form. Parents or guardians are to complete the form for children under the age of 18. The Office of Housing has been given permission to use this form for gathering race and ethnic data in assisted housing programs. Completed documents for the entire household should be stapled together and placed in the household s file. 1. The two ethnic categories you should choose from are defined below. You should check one of the two categories. 1. Hispanic or Latino. A of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term Spanish origin can be used in addition to Hispanic or Latino. 2. Not Hispanic or Latino. A not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. 2. The five racial categories to choose from are defined below: You should check as many as apply to you. 1. American Indian or Alaska Native. A having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. 2. Asian. A having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam 3. Black or African American. A having origins in any of the black racial groups of Africa. Terms such as Haitian or Negro can be used in addition to Black or African American. 4. Native Hawaiian or Other Pacific Islander. A having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 5. White. A having origins in any of the original peoples of Europe, the Middle East or North Africa. 2 form HUD H (9/2003)