PLAZA SOUTH Fact Sheet Henry Phipps Plaza South, Located in the Kips Bay area of Manhattan, is pleased to announce that applications are now being accepted for studio, one, two, three and four bedroom apartments for the waiting list. Households must meet the below income and family size requirements. Apartment Type Family Size* Monthly Rent** Total Annual Income*** 0 Bedroom 1 $952 $32,640 - $38,100 1 Bedroom 1 $34,971 - $38,100 $1,020 2 $34,971 - $43,500 2 Bedroom 2 3 4 $1,224 $41,966 - $43,500 $41,966 - $48,960 $41,966 - $54,360 4 $48,446 - $54,360 3 Bedroom $1,413 5 $48,446 - $58,740 5 $54,034 - $58,740 4 Bedroom $1,576 6 $54,034 - $63,060 *Household size includes everyone who will live with you, including parents and children. Subject to occupancy criteria **Rent subject to change and Includes electric and gas for cooking ***Household earnings include salary, hourly wages, tips, Social Security, child support, and other income for household members. Income guidelines adjusted for family size ALL APPLICANTS WILL BE REQUIRED TO MEET INCOME, CREDIT, BACKGROUND CHECK AND OTHER CRITERIA Qualified Applicants will be required to meet income guidelines and additional selection criteria. To request an application, mail a POSTCARD to: Henry Phipps Plaza South, 902 Broadway, 13 th Floor, New York, NY 10010 or download from http://www.phippsny.org/housing-application/. Completed applications must be returned by regular mail only (no priority, certified, registered, express or overnight mail will be accepted) to the post office box number that will be listed on the application, and must be postmarked by October 11, 2016. Applications postmarked after October 11, 2016 will be set aside for possible future consideration. Applications will be selected by lottery; applicants who submit more than one application will be disqualified. Disqualified applications will not be accepted. Please note that applications will be selected via a lottery and placed on the waiting list. Applications will be interviewed based on the future availability of vacant units. NO BROKERS FEE. NO APPLICATION FEE. SUPERVISED BY DEPARTMENT OF HUD
Log# For official use only APPLICATION FOR HENRY PHIPPS PLAZA SOUTH MAIL ONLY ONE (1) APPLICATION PER FAMILY. SEND BY REGULAR MAIL ONLY. (DO NOT SEND BY REGISTERED OR CERTIFIED MAIL.) THIS APPLICATION MUST BE POST MARKED NO LATER THAN OCTOBER 11, 2016. MAIL TO: HENRY PHIPPS PLAZA SOUTH P.O. BOX 356 243 5 th AVENUE NEW YORK, NY 10016 Not every application received by HENRY PHIPPS PLAZA SOUTH will be opened. Each selected application will be recorded. Since so many families/elderly need housing, this development will not be able to accommodate all who are eligible. Each selected applicant will be contacted regarding the status of his or her application. NO PAYMENT OR FEE SHOULD BE GIVEN TO ANYONE IN CONNECTION WITH THE PREPARATION FILING OR PROCESSING OF THIS APPLICATION FOR HOUSING. THIS INFORMATION IS TO BE FILLED OUT BY THE APPLICANT. Name: Street address: City: State: Home Phone No.: Work Phone No.: Cell Phone No.: Email Address: Mailing Address (if different from above): Housing Information Do you live in Public Housing, City/ State Assisted Housing or other Federally- Assisted Housing YES NO If YES, Name of Development Project # Is your rent presently subsidized through section 8? YES NO Do you have a portable or transferable section 8 voucher? YES NO If yes, how long have you had your voucher? Current Landlord s Name: Current Landlord s Address: Landlord s Phone No.: What is your present monthly rent? $ How much do you contribute to the monthly rent? $ (If you do not contribute anything write0)
How many persons are in your household? How man bedrooms do you have? How long have you lived at this address? Name/Address of prior landlord: Name/ Address of landlords for the past five years: Check the utilities paid by you monthly and indicate the average monthly amount: Gas $ Electric $ Heat $ Water $ *List everyone who will live in the unit for which you are applying: ALL LISTED HOUSEHOLD MEMEBERS (18 YEARS OR OLDER) MUST BE PRESENT AT OFFICE INTERVIEW, IF YOUR APPLICATION IS SELECTED. Name Relationship to HOH 1. Head Sex (M / F) Age Date of Birth Occupation (write in student if attending school) 2. 3. 4. 5. 6. How many persons, including yourself, will live in the unit for which you are applying? *Information used to determine apartment size only. Are there any adult members of your household that are attending technical, trade school on a full time basis? If yes, please list name and school they are attending Are you or a member of your household disabled? YES NO If yes, would you describe the disability as ( ) mobility? ( ) Visual? ( ) Hearing? If you checked either mobility impairment, visual impairment or hearing impairment, do you or a member of your household require a special accommodation? ( ) YES ( ) NO If yes, please remember to place a check mark on the outside of your envelope, and please specify the special accommodation required: If there are members of your household who are disabled, REMEMBER TO CHECK THE BOX ON THE FRONT OF THE RETURN ENVELOPE.
INCOME FROM EMPLOYMENT: List all fulltime and or part-time employment for ALL HOUSEHOLD MEMBERS including yourself WHO WILL BE LIVING WITH YOU in the residence for which you are applying. Include self-employed earnings. 1. Household Member Name & Address of employer Length of employment (From / To) Status F= Full-time P= Part-time S= Self employed Gross Annual Earnings 2. 3. 4. 5. 6. Total Gross Annual Employment Income = Please answer the following: Do all prospective residents have an Alien Registration card? Yes No if yes, list names and registration card number: Are you and/or the 18yr. old occupants eligible for employment in this country? INCOME FROM OTHER SOURCES: List all other income, for example, welfare (including housing allowance), AFDC, Social Security, S.S.I., Pension, disability compensation, Unemployment compensation, Interest income, Babysitting, Caretaking alimony, Child support, Income from rental property, and Armed Forces Reserves. Household Member Source of income Gross Amount Period Received Weekly, Bi-weekly, Semi-monthly, Monthly, Quarterly 1. $ Per $ Annual Gross Amount 2. $ Per $ 3. $ Per $ 4. $ Per $ 5. $ Per $ 6. $ Per $ Total Gross income From Other Source = GRAND TOTAL GROSS ANNUAL INCOME: (employment & Other Income) = $ $
ASSETS: List below the current cash value of all assets held by ALL household members, including you. Include below: Checking account, Savings account, Savings bonds, Certificates of Deposit, Money Market funds, Mutual funds, Stocks, Bonds, IRA accounts, 401K accounts, other retirement and pension accounts, trust funds, Life Insurance Policies (except Term), Personal property held as an investment (e.g. Jewelry, Antiques or art), equity in real estate and all other assets. Household Member Institution Name Type of Asset Current $ Value / Account Balance TOTAL ASSET VALUE: Do you NOW own Real Estate? YES NO If YES, what is the value? Have you EVER owned Real Estate? YES NO If YES When? GENERAL How did you hear about this development? (Please check one) Sign Posted on Building Friend Newspaper Housing List Local Organization or Church Other ETHNIC IDENTIFICATION (Used for statistical purpose only) This Information is optional and will not affect the processing of the application. Please check one group which best identifies the application. Hispanic or Latino Black or African American Non Hispanic or Latino Native Hawaiian or Pacific Islander America Indian or Alaska Native White Asian Other PLEASE DO NOT MAIL MORE THAN ONE APPLICATION PER FAMILY. YOU WILL BE DISQUALIFIED IF MORE THAN ONE APPLICATION PER FAMILY IS RECEIVED OR PHOTOCOPY OF AN APPLICATION. I DECLARE THAT STATEMENTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I FURTHER DECLARE THAT NEITHER I, NOR ANY MEMBER OF MY IMMEDIATE FAMILY ARE EMPLOYED BY THE NEW YORK CITY HOUSING DEVELOPMENT CORPARATION OR ITS SUBSIDIARIES OR THE OWNERS OR ITS PRINCIPLES. WARNING: WILLFUL, FALSE, MISLEADING, OR INCOMPLETE INFORMATION IN THIS APPLICATION WILL BE GROUNDS FOR REJECTION OF APPLICATION. SIGNATURE DATE: