Kenneth Henry Court 6475 Foothill Blvd. Oakland, CA 94605 (50) 638-4383 Dear Applicant, Thank you for your interest in becoming a resident of Satellite Affordable Housing Associates. Below is some important information you should know about the process before applying. Applications must be submitted in person or by mail to 6475 Foothill Blvd., Attn: Manager s Office, Oakland, CA 94605. Only complete and original applications will be accepted. Please do not use white-out on the application. You will receive a confirmation after your application is received. You will be contacted when a vacancy becomes available. Please note it is not our policy to disclose to applicants their specific positions on the waiting list. If your household is over-income, or otherwise unqualified, your application will be denied. You will receive written notification and instructions on the appeal process. It is the applicant s responsibility to notify management of address or telephone number changes. If we are unable to contact you, your application will be removed from the waiting list. Federal regulations require that management recertify each household s income and assets annually. Management must also regularly inspect apartments to ensure that they are suitable for occupancy. All applicants are subject to the Resident Selection Criteria on the following page: Kenneth Henry Court Application Instructions & Information Page i of iii 5/7/04
Credit History Management will review an applicant s credit history for the past three (3) years from the date the credit report is generated. Judgments, Liens & Bankruptcies An applicant cannot have judgments, liens, and bankruptcies within the last three (3) years from the date the credit report is generated. Judgments, liens and bankruptcies that are filed more than three (3) years from the date the credit report is generated are excluded, so long as no additional bad debt, past dues, collection accounts, and judgments occur since the filing date. Evictions Applicants with an eviction reported within the last five (5) years from the date the credit report is generated will not be accepted. Landlord Reference Checks Management will verify residency with current and prior landlords for the past five (5) years. We are specifically looking at payment history, incidents of damage and/or housekeeping issues, lease violations and eviction proceedings. If a negative landlord reference is received, applicant will not be accepted. Criminal & Sex Offender Screening An applicant convicted of drug-related criminal activity for manufacture or production of methamphetamine on the premises of federally assisted housing will not be admitted under any circumstances. An applicant who is subject to lifetime registration requirement under a state sex offender program will not be admitted under any circumstances. An applicant whose abuse or pattern of abuse of alcohol interferes with the health, safety, or peaceful enjoyment of the premises by other residents will not be admitted. An applicant who has been convicted of the following in the last seven (7) years will not be admitted: Drug related criminal activity or violent criminal activity will not be admitted; Other criminal activity that would threaten the health, safety or right to peaceful enjoyment of the premises by other residents, owner, any employee, contractor, subcontractor or agent of the owner who is involved in the housing operations will not be admitted. Kenneth Henry Court Application Instructions & Information Page ii of iii 5/7/04
04 Minimum & Maximum Income Limits for Alameda County Based on Household Size Number of People in Household Maximum Income Person 38,640 Persons 44,60 3 Persons 49,680 4 Persons 55,00 5 Persons 59,640 6 Persons 64,080 7 Persons 68,460 8 Persons 7,900 9 Persons 77,80 (Income Limits are subject to change.) Apartment Size Minimum Income -Bedroom 7,400 -Bedroom 7,664 3-Bedroom 0,400 4-Bedroom,67 (There is no minimum income requirement for households with Section 8 assistance. Minimum income figures are subject to change.) Occupancy Limits Apartment Size Maximum Number of People in Household -Bedroom 3 -Bedroom 5 3-Bedroom 7 4-Bedroom 9 Eligibility The head-of-household must be 8 years or older. Special Set-Asides There are a certain number of units with Project-Based Section 8 where applicants must qualify under Oakland Housing Authority s screening process. Kenneth Henry Court Application Instructions & Information Page iii of iii 5/7/04
Kenneth Henry Court Rental Application We are currently only accepting applications for,, & 3-bedrooms. Please print in black or blue ink, mark n/a in blanks, and do not use whiteout. Unit size preferred: -bedroom -bedroom 3-bedroom Unit type preferred: Tax Credit Project-Based Section 8 preference Applicants Name (please print) Date of Birth List below all persons who will be living in the apartment. Social Security Number Male/ Female Relationship to Head of Household.. 3. 4. 5. 6. 7. Head of Household Contact Information Current Street Address Unit # City State Zip Mailing (if different) Street Address Unit # City State Zip Phone : Phone : Kenneth Henry Court Rental Application Page of 8 3/3/04
Household Income Information Complete for every household member. Attach separate sheet if you have additional sources. Income Sources Income Sources Income Sources Total Kenneth Henry Court Rental Application Page of 8 3/3/04
Household Asset Information Complete for every household member. Attach separate sheet if you have additional sources. Assets 3 Checking Account #: Savings Account #: Other Asset Account #: If this is a joint account, please list other account holders: Account Type: Assets 3 Checking Account #: Savings Account #: Other Asset Account #: If this is a joint account, please list other account holders: Account Type: Assets 3 Checking Account #: Savings Account #: Other Asset Account #: If this is a joint account, please list other account holders: Account Type: Kenneth Henry Court Rental Application Page 3 of 8 3/3/04
Residential History Starting with your current residence, please include the following information for the past five years for all household members. Residential History Applicant Name: Attach separate sheet if you have had additional residences. Landlord Name: Current Move-in Date: Move-out Date: Monthly Rent: Rent Own In program/shelter With family/friends Landlord Landlord Landlord Applicant Name: Landlord Name: Previous Move-in Date: Move-out Date: Monthly Rent: Rent Own In program/shelter With family/friends Landlord Landlord Landlord Applicant Name: Landlord Name: Previous 3 Move-in Date: Move-out Date: Monthly Rent: Rent Own In program/shelter With family/friends Landlord Landlord Landlord If you do not have five years of residential history, please explain why below. Lack of residential history does not necessarily disqualify you (verification may be required). Kenneth Henry Court Rental Application Page 4 of 8 3/3/04
Household Information. Has anyone in your household been evicted from any residence for any reason within the last five years? If yes, please explain, including who and when:. Has your residency/tenancy or government assistance in a subsidized housing program ever been terminated for fraud, non-payment of rent, failure to comply with re-certification procedures, or any type of criminal activity? If yes, please explain, including who and when: 3. Do you have a current, transferable Section 8 voucher or other similar subsidy? If yes, what agency is your subsidy through? 4. Do you expect changes to your household size within the next months? If yes, please explain: 5. Is anyone in your household separated, but not divorced? If yes, please list names: 6. Are any household members full-time students or planning to become full-time students within the next twelve months? If yes, please list names: 7. Do you or anyone else in your household have any pets? If yes, please describe what type and how many: 8. Have you or any household member been convicted of a felony within the past 7 years? If yes, please explain: 9. Are you or any household member required to register as a sex offender in any state? If yes, list state of registration: 0. Are you being displaced from your home by a result of a government action or a presidentially declared disaster? If yes, please explain: Kenneth Henry Court Rental Application Page 5 of 8 3/3/04
Optional Information Ethnic Categories Please check one only: Hispanic or Latino t Hispanic or Latino Racial Categories Please check all that apply: Alaskan Native or American Indian Black White Asian Native Hawaiian or Other Pacific Islander Other (Please Specify): Special Unit Requirements. Do you, or does any member of your family have a condition that requires: A barrier-free apartment Unit for hearing impaired Unit on first floor Unit for vision impaired. Will you or any of your family members require a live-in aide to assist you? If yes, please explain: 3. If you checked any of the above categories of units, please explain exactly what you need to accommodate your situation: 4. What is the name of the family member who needs the features identified above? 5. What is the name of the physician or social services agency to be contacted to verify your need for the features you have identified above? Alternate Contact Person Name: Relation: Agency: Phone : Phone : How did you find out about this property? Kenneth Henry Court Rental Application Page 6 of 8 3/3/04
Certification. I/we understand that it is the responsibility of each applicant to provide any and all information required to determine eligibility.. I/we understand that if an applicant fails to meet the eligibility requirements of the Resident Selection Criteria, a written notice of denial stating the reason for denial will be mailed to applicant. An applicant has 4 days to request an appeal. 3. I/we understand that the above information is being collected to determine my/our eligibility for residency. I/we authorize the owner, its agents and employees to make any and all inquiries to verify this information either directly or through information exchanged now or later with rental, or credit screening services, or law enforcement or other public agencies, and to contact previous or current landlords or other sources for credit and/or verification information which may be released by appropriate federal, state, local agencies, or private persons to the management. 4. I/we authorize the owner, its agents and employees to obtain one or more consumer reports as defined in the Fair Credit Reporting Act, 5 U.S. C. Section 68a(d), seeking information on my/our creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. 5. I/we authorize the owner, its agents and employees to obtain information about my/our background to see if there is any criminal history, including arrests or convictions which may prohibit me/us from moving onto the property, in compliance with our Resident Selection Criteria. 6. I/we understand I/we must provide written notification to management of any changes to the information on this form. 7. If my/our application is approved and move-in occurs, I/we certify that only those persons listed in this application will occupy the apartment, that I/we will maintain no other place of residence, and that there are no other persons for whom I/we have or expect to have responsibility for providing housing. 8. I/we understand that an applicant with a disability has a right to request a reasonable accommodation. All requests will be evaluated and a decision will be made based on the reasonable nature of the request. 9. I/we certify that the foregoing information is true, complete, and correct. I/we understand that false statements or omissions are grounds for disqualification, eviction, and/or prosecution under the full extent of California law. [Signatures to follow on next page] Kenneth Henry Court Rental Application Page 7 of 8 3/3/04
Signature Please ensure that your application is complete and that all adult applicants have signed and dated below. Head of Household: Name: Signature: Date: Applicant : Name: Signature: Date: Applicant 3: Name: Signature: Date: Kenneth Henry Court Rental Application Page 8 of 8 3/3/04