Applicatin Instructins Effective February 8, 2013 D Step 1. Dwnlad and review the Admissins & Occupancy Plicy fr the prperty yu are interested in. Step 2. Dwnlad and print a cpy f the Applicatin Packet (this file). D Step 3. Dwnlad and print a cpy f the Tenant Incme Questinnaire fr every adult member f the husehld age 18 r lder during the first year f the Lease wh will ccupy the apartment. Applicatin (First 3 pages) Step 4. Write the Name f the Cmmunity yu are applying t n the first line. Dalehaven Estates Central Canal Hmes / MLK Hmes II Shannn Glenn Apartments D Step 5. Leave the next line blank (i.e. Apartment Number, Rent Amunt, Qualify At). This will be filled in by the manager during the apprval prcess. Please refer t the Admissin & Occupancy Plicy D Step 6. Fill in the name f the c-applicants (anyne ver the age f 18 during the first year f the Lease) D Step 7. Fill in the Remaining infrmatin COMPLETELY. Incmplete applicatins will hld up mve in dates and have t be resubmitted. Head f Husehld will be the same thrughut this applicatin. All ccupants must be listed in the husehld cmpsitin sectin, including c-applicants etc. Applicant Criminal & Credit Check Release and Authrizatin Frm (Next 1 page) Step 8. Each applicant age 18 and lder during the first year f the Lease must fill ut this Credit & Criminal Authrizatin. Fill ut frm COMPLETELY except the "Fr Office Use Only" sectin f the page. This will be filled in by the manager during the apprval prcess. Please refer t the Admissin & Occupancy Plicy Landlrd Reference Check (Last 2 pages) Step 9. Leave entire frm blank, the manager will fill in infrmatin fr each Landlrd listed n yur applicatin and/r credit check. Step 10. Only sign and date page 2, under "Applicant/Tenant Signature" after reading the RELEASE statement abve signature line. Page 1
Return Frms t the Cmmunity Step 11. Mail r Deliver all frms t the apprpriate cmmunity in which yu are applying fr. Include a mney rder r cashier's check fr each applicant ver the age f 18 during the first year f the Lease fr the applicatin fee. N cash r persnal checks will be accepted. Refer t the Admissin and Occupancy Plicy fr the amunt r cntact the manager. Dalehaven Estates 3700 Justus Curt Evansville, IN 47714 Ph: (812) 479-0411 Central Canal Hmes / MLK Hmes II 1426 W. 29th Street Suite 210-A Mailbx 11 Indianaplis, IN 46208 Ph: (317) 222-1670 Shannn Glenn Apartments 280 Shamrck Curt Evansville, IN 47715 Ph: (812) 476-7576 General Ntes Use the same pen thrughut the applicatin. If yu make any mistakes, draw a line thrugh yur mistake (d nt scribble it ut), place yur initials next t the mistake, and crrect the answer. D nt use white ut. This will vid yur applicatin, and it will have t be resubmitted. Once all the infrmatin has been filled ut, submit the riginals t the apprpriate persn at the management ffice. These items can be mailed t the ffice using the address n ur website. Dn't frget t include the Applicatin Fee fr every adult member f the husehld in accrdance with the prperty's Admissin & Occupancy Plicy. If yu have any questins, please d nt hesitate t call r e-mail the management staff. Once yu applicatin is received, management will begin prcessing it in accrdance with the prperty's Admissin and Occupancy Plicy. Any blank items r incrrectly filled ut infrmatin will delay the prcessing f applicatins. THANK YOU FOR CHOOSING OUR PROPERTY TO CALL HOME!! Page 2
RENTAL HOUSING APPLICATION NAME OF APPLICANT: NAME OF CO-APPLICANT: (if applicable additinal applicatin must be cmpleted) NEW APPLICATION HOUSEHOLD ADDITION TRANSFER (Please Print) Time: A) Name: Phne: ( ) B) Address: (Street) (City) (State) (ZIP) C) Marital Status: Divrced / Widwed / Married / Single (Never Married) / Separated D) Driver's License # and State: HOUSEHOLD COMPOSITION List all persns that will be ccupying the unit. Full Name Relatinship t Head f Husehld Birth Date Scial Security Number Emplyed Student Head f Husehld - - Y / N Y / N - - YIN Y/N RENTAL HISTORY -- Last Tw Years Use Additinal sheet if necessary D) Present Landlrd Name: Phne: ( ) Landlrd Address: City: St: ZIP: Dates f Occupancy: t Related? Y/N Hw? E) Previus Address: Previus Landlrd Name: Phne: ( ) Landlrd Address: City: St: ZIP: Dates f Occupancy: t Related? Y/N Hw? F) Previus Address: Previus Landlrd Name: Phne: ( ) IHCDA Cmpliance Frm #18 Revised 1/1/11
Landlrd Address: Dates f Occupancy: t City: St: ZIP: Related? Y/N Hw? GENERAL QUESTIONS 1) yes n Have yu r any husehld member ever been cnvicted f a felny? 2) yes n Have yu ever been evicted? Reasn: 3) yes n Have yu r any husehld member been arrested/cnvicted f a drug related crime? 4) yes n Des anyne nt listed in the husehld cmpsitin n page ne plan t live with yu in the next 12 mnths? If yes, explain 5) yes n Will the Husehld be receiving Sectin 8 husing assistance? (If yes list agency name, cntact persn and phne number.) 6) yes n Are there any absent husehld members wh under nrmal cnditins wuld live with yu? 7) yes n Des an adult f this husehld have primary physical custdy f every child listed n this applicatin? 8) yes n Des yur husehld have r anticipate having any pets ther than thse used as a service animal? 9) yes n Des anyne in yur husehld have special needs? If yes explain? Lans: Credit Cards: Other: CREDIT REFERENCES CHARACTER REFERENCES Name: Relatinship: Phne: Name: Relatinship: Phne: IHCDA Cmpliance Frm #18 Revised 1/1/11
EMERGENCY CONTACT NUMBER In case f emergency, ntify: Hme Phne: ( ) Wrk Phne: ( ) Applicant certifies the abve infrmatin is true and accurate and understands that false r inaccurate infrmatin shall be cause fr denial f this applicatin r terminatin f any subsequent rental agreements. I/We are the nly persn(s) wh will reside in the apartment if this applicatin is apprved. Apartment wner r agents may verify all infrmatin given directly r thrugh reprting agencies. Acceptance f the applicatin is nt binding n apartment wner r agent until apprved in writing. Yu have applied t live in an apartment that is gverned by the Lw Incme Husing Tax Credit Prgram. This Prgram requires us t certify all f yur incme asset and eligibility infrmatin as part f determining yur husehld's eligibility. Prgram requirements state we must verify each incme and asset surce as well as ther claims f eligibility. We must determine this prir t granting yur eligibility and, if such eligibility is granted, each subsequent year yu remain in the unit. The undersigned is the persn(s) named abve and hereby authrizes Apartment Credit Services t cnduct a search f my Criminal Recrd, Plice Recrd and Mtr Vehicle Recrd infrmatin fr the purpse f btaining husing. Additinally, I authrize all cmpanies and law enfrcement agencies t release such infrmatin, and release them frm any liability and respnsibility frm ding s. A faxed cpy f this authrizatin shall be as valid as the riginal. If applicant cancels after tw (2) days, all mneys depsited shall be frfeited t the apartment wner. If apprved all mneys depsited with this applicatin will be applied tward security depsit and/r prcessing fee at wner's discretin. If an applicatin is denied fr ANY reasn a 90-day wait perid is required befre reapplying t this prperty. Head Signature: C-head Signature: Agent's Signature:.0, We encurage and supprt the natin's affirmative husing prgram in which there are n barriers t btaining husing because f race, clr, religin, sex, natinal rigin, handicap r familial status. IHCDA Cmpliance Frm #18 Revised 1/1/11
APPLICANT CRIMINAL & CREDIT CHECK RELEASE AND AUTHORIZATION FORM hereby authrize Shannn Glenn Apartments r ther authrized representative f the apartment cmmunity bearing this release, r cpy theref, t btain any infrmatin pertaining t criminal curt recrds and credit infrmatin. I hereby direct yu t release such infrmatin t Shannn Glenn Apartments r ther authrized representative f the apartment cmmunity hereby fully release and discharge Shannn Glenn Apartments, their emplyees, agents, attrney, and their respective affiliates frm all claims and damages arising ut f r relating t any investigatins f my backgrund fr residency at Shannn Glenn Apartments. Name: First, Middle, Last Print Clearly Other Name / Alias / Maiden Name: Date f Birth: Scial Security N: Hw lng have yu been at yur current address? Current Address: Street City, State, Zip Cde Have yu ever been cnvicted fr any crime, including sex-related r child-abuse related ffenses? N Yes FOR OFFICE USE ONLY: Credit Check Did the Applicant meet the screening criteria? Criminal Check Did the Applicant meet the screening criteria? Is the Applicant listed n the IN Sheriffs' Sex & Vilent Offender Registry? Landlrd Reference Check Did the Applicant meet the screening criteria? Signature f Apprval:
LANDLORD REFERENCE CHECK TO: FROM: Shannn Glenn Apartments 280 Shamrck Curt Evansville, IN 47715 Phne: Phne: (812) 476-7576 Fax: Fax: (812) 476-2761 Applicant Name: Date f Birth: Scial Security Number: T Be Cmpleted By Office Staff Apartment Cmmunity Applying Fr: Shannn Glenn Apartments Reference Perfrmance Methd: Telephne Persn-t-Persn Written Name f Persn Perfrming Reference Check: Previus Address: Landlrd Name: Phne Number: Fax Number: Type f Residence: Apartment 1.1 Hme Other Type f Landlrd: Management C. Real Estate C. L Private Owner T Be Cmpleted By Current r Previus Landlrd N, the named abve has NOT rented frm my agency. Yes, the named abve has rented frm my agency. 1. Dates f Occupancy: Frm: T: 2. Mnthly Rent Amunt: 3. N. f Occupants: 4. N. f Late Payments: 5. N. f Returned Checks: 6. N. f Disturbance Cmplaints: 7. N. f Times Plice Called: Page 1 f 2
YES NO Did the resident, family r guests damage the prperty? 0 0 Did the resident pay fr the damages? 0 Did the resident vilate the lease agreement in any way? Li Did the resident vilate any f yur huse rules in any way? Did the resident give prper ntice fr vacating the unit? Wuld yu rent t this individual again? Did the resident have any pets? 0 Additinal Cmments: Signature f Persn Supplying this Infrmatin Date RELEASE: I hereby authrize the release f the requested infrmatin. Infrmatin btained under this cnsent is limited t infrmatin that is n lder than 12 mnths. There are circumstances that wuld require the wner t verify infrmatin that is up t 5 years ld, which wuld be authrized by me n a separate cnsent attached t a cpy f this cnsent. Applicant/Tenant Signature Date NOTE TO APPLICANT/TENANT: Yu d nt have t sign this frm if either the requesting rganizatin r the rganizatin supplying the infrmatin is left blank PENALTIES FOR MISUSING THIS CONSENT: Title 18, Sectin 1001 f the U.S. Cde states that a persn is guilty f a felny fr knwingly and willingly making false r fraudulent statements t any department f the United States Gvernment. HUD and any wner (r emplyee f HUD r wner) may be subject t penalties fr unauthrized disclsures r imprper uses f infrmatin cllected based n the cnsent frm. Use f the infrmatin cllected based n this verificatin frm is restricted t the purpse cited abve. Any persn wh knwingly r willingly requests, btains, r disclses any infrmatin under false pretenses cncerning an applicant r participant may be subject t a misdemeanr and fined nt mre than $5,000. Any applicant r participant affected by negligent disclsure f infrmatin may bring civil actin fr damages and seek ther relief, as may be apprpriate, against the fficer r emplyee f HUD r the wner respnsible fr the unauthrized disclsure f imprper use. Penalty prvisins fr misusing the scial security number are cntained in the Scial Security Act at **208 (a) (6), (7) and (8).** Vilatins f these prvisins are cited as vilatins f 42 USC **408 (a) (6), (7) and (8).** Page 2 f 2