401 E. Carson St. Carson, CA (424)

Transcription

1 01 E. Carson St. Carson, CA 9075 () Dear Applicant: Thank you for your interest in Via 5 Apartments. In response to your request, attached you will find a Rental Application form. Please read through all sections carefully and write your responses clearly and thoroughly. All areas of the application must be completed where applicable, or it cannot be processed. Application may be dropped off at our leasing office or mailed to: Via 5 Apartments 01 E. Carson St. Carson, CA 9075 If any applicant willfully and knowingly submits false information, his/her application will be rejected. Please check your responses thoroughly before mailing out your Rental Application, to ensure that all areas are filled out and for accuracy. In order to qualify for this housing opportunity provided under a federal affordable housing program, the following criteria apply: LIHTC Low Income Housing Tax Credit Income Limits Size Maximum Income Limits 1 person $7,860 person $,60 person $8,660 person $5,060 5 person $58,0 6 person $6,760 Bedroom Size Minimum Income Limits 1BR $15,10 BR $18,0 BR $1,090 Rents range from $67 to $1* *Note: Income limits and rents are subject to change based on area median income data, published annually by HUD. **Due to the limited number of these affordable apartments, the filing of a rental application in no way guarantees you an apartment. EQUAL HOUSING OPPORTUNITY

2 Application For Occupancy Via5 Apartments 01 E. Carson St., Carson, CA 9075 Ph. () Via5 Apartments is a Smoke-Free Facility For office use only received Application # This information is to be filled out by the head of the household. Please complete all sections and have all adult household members sign the last page. Name: Street Address/Apt #: City, State: Zip Code: Home Phone: Work Phone: Address: Check what size units you would want to be considered for: One Bedroom Two Bedroom Three Bedroom Please indicate if you are requesting a unit with special accommodations for any member of your household due to: Mobility Visual Hearing disability. Housing Status Current Landlord/Name and Address: City, State: Zip Code: Landlord Telephone Number: Managing Agent Telephone Number: Is the apartment lease in your name? Are you sharing your apartment? Is your landlord a relative? Monthly rent: $ How much do you contribute to the monthly rent? $ (If you do not contribute anything, write 0 ) How long have you lived at this address? years months Do you pay your own rent? Reasons for wanting to move? If not, who does? Does your rent include utilities? Average monthly utility expenses: $ Please check the size of your current residence: 1-Bedroom -Bedroom -Bedroom -Bedroom Other: PREFERENCES 1- Have you been displaced from your residence, pursuant to California Health and Safety Code Section 11. or successor statute? - Do you reside in the City of Carson? Do you currently have a Section 8 voucher? List your prior addresses information below, if you have lived at your current address for less than 5 years: Previous Address (1) Landlord/Property Name Telephone Number Reason for moving: How long have you lived at this Previous rent per month: address? Previous Address () Landlord/Property Name Telephone Number

3 Information List all persons who will occupy the apartment, including yourself and persons anticipated to join the household (e.g., unborn child/children of expectant household members, children to be adopted, etc): Full Name Relationship to Head-of- Sex Birth date Social Security # Driver s License # State 1 HEAD OF HOUSEHOLD Income from Employment List all current full- and/or part-time employment income for all household members. (Include self-employment gross earnings and net taxable income.) See below for non-employment sources of income. Member Occupation Name and Address of Employer Length of Employment Gross Earnings Before Any Payroll Deductions and Taxes Income from Other Sources (Examples: List all Social Security, S.S.I., AFDC/TANF, pension, disability compensation, Armed Forces regular and special pay, unemployment compensation, alimony, child support, annuities, dividends, income from rental property, recurring monetary contributions, interest income, babysitting, care-taking, scholarships, and/or grants etc., ALSO ANY OTHER SOURCE OF INCOME NOT PREVIOUSLY LISTED): Member Type of Income Amount

4 Assets Complete each category as applicable. Checking Account Name of Bank: Account Number: Savings Account Name of Bank: Account Number: Balance/: $ / as of Balance/: $ / as of Money Market Account Savings Certificate Name of Bank Name of Bank Account Number: Balance/: $ / as of Account Number: Balance/: $ / as of Do you receive any income (either earned and/or unearned) in the form of a prepaid debit card? Stocks and Bonds Value: $ Do you own any real estate? Have you ever owned any real estate? Has any adult family member sold, given away, or otherwise disposed of any assets during the past two years? Balance/: $ / as of Savings Bond/s Value: $ If yes, what is the current value? If yes, when? When sold? For how much? If yes, list each asset and the amount received for each asset. Educational Background 1) List all persons who attend school presently: member School Name/Address Major Full or Part time 1 ) Complete for all other household members: member Did you complete High School or equivalent? Did you complete College or equivalent? Major/Field Highest Grade level completed or degree received 1 Program Information Do you presently reside in a development where your rent is based upon your income? If yes, explain: How did you hear about our development? Why are you applying to our development? Were you or any member of your household ever convicted of a felony? Have you or any member of your household ever been evicted?

5 Has anyone in your household been convicted of violating any drug-related laws? I acknowledge that a criminal background check of all adult household members will be part of the application process and I approve it. Signature of head of household I DECLARE THAT THE STATEMENTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. Signature of head of household: WARNING: MISLEADING WILLFUL FALSE STATEMENTS, MISREPRESENTATIONS, OR INCOMPLETE INFORMATION IN THIS APPLICATION WILL BE GROUNDS FOR REJECTION OF THIS APPLICATION. Attention Duplicate applications or applications submitted by more than one household member will not be accepted. The filing of this application in no way guarantees you an apartment. Positively no pets, large appliances, or waterbeds are permitted without the owner s prior written approval and signed agreement. We do not insure your personal property; we encourage you to purchase renter s insurance for your personal belongings.