Villages of Taylor Subsidized Housing

Villages of Taylor Subsidized Housing

Preliminary Application
Please note: The information you provide on this application will be treated as confidential. It includes both information necessary for determining your eligibility for housing, and information required for statistical purposes. The race, ethnicity, and gender information is requested in order to assure the Federal government that Federal laws prohibiting discrimination against applicants are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. Please answer each question as completely as possible. Any information found to be incomplete and/or falsified will cause the application to be denied and not processed.

The one bedroom wait list is currently closed.

The two and three bedrooms wait lists are open indefinitely.

2 Bedroom (2 – 4 people)
3 bedroom (4 – 6 people)

How did you hear about us?
For marketing purposes, please let us know how you heard of us: *

Newspaper Drive By Resident Referral Word of Mouth Website Friend / Family
Unit Size
What size home are you applying for? *

2 bedroom (2 - 4 people) 3 bedroom (4 - 6 people)

Applicant Contact Information
Phone Number *

Area Code Phone Number
Email *
example@example.com
Name *

First Name Middle Name Last Name
Address (P.O. BOX ADDRESSES WILL NOT BE ACCEPTED) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Income

Please enter numerical values only. "N/A" will result in an incomplete application.
Total Household MONTHLY Earned Income *
ex. wages, self-employment, numerical values only
Total Household MONTHLY Other Income *
ex. Social Security, SSI, Cash Assistance, numerical values only

Rental History

If living with friends or family, please complete as if they are your landlord. "N/A" will result in an incomplete application.
Current Landlord Name *

First Name Last Name
Current Landlord Street Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dates of Residency
From *

Month Day Year
Present
To *

Month Day Year
How much do you currently pay for rent? *
If you do not pay rent, please enter $0. "N/A" will result in an incomplete application.
List all states that you or any family member have ever lived in, including the state you currently live in. *
Example: Michigan - N/A is not an acceptable answer

Certification and Consent to Release of Information
By submitting this application, I certify the accuracy if the information contained herein. I understand that the Department of HUD is authorized to collect this information to determine eligibility, appropriate bedroom size, and the amount my family will pay for rent. I also understand that this will be my only residence. I authorize management to contact my present/prior landlords for information regarding my tenancy, and to access records pertaining to me which may be on the file with the credit bureau authorities. I authorize a criminal background check and a check of the state/national sex offender registry for all adult household members. I understand that all information I have listed is subject to verification and that a final decision on eligibility cannot be made until all verifications are complete. I understand that it is a crime to knowingly provide false information for the purpose of obtaining or maintaining occupancy in, and/or, for the purpose of securing lower rent, in a subsidized housing unit, and that the penalty for knowingly providing false information is up to five years in prison and/or $10,000 fine upon conviction. I hereby do swear and attest that all of the information herein about me is true and correct. I understand that if no unit is currently available and I am put on a waiting list, I must update all information about my household at the time that a unit is available to be offered.

All applicants 18 years of age or older must sign this preliminary application. If a co-head is listed on this application, the co-head must also provide their signature. Preliminary applications received without all 18 year old and over signatures will not be processed.

It is the policy of this company to provide an equal opportunity basis. We do not discriminate on the basis of race, color, national origin, ancestry, sex, disability, religion, familial status, sexual orientation, gender identity, or medical condition.
Head of Household E-Signature *

Clear
Additional Adult #1 Signature *

All applicants 18 years of age or older must sign this preliminary application. If a co-head is listed on this application, the co-head must also provide their signature. Preliminary applications received without all 18 year old and over signatures will not be processed. Clear
Additional Adult #2 Signature *

All applicants 18 years of age or older must sign this preliminary application. If a co-head is listed on this application, the co-head must also provide their signature. Preliminary applications received without all 18 year old and over signatures will not be processed. Clear
Additional Adult #3 Signature *

All applicants 18 years of age or older must sign this preliminary application. If a co-head is listed on this application, the co-head must also provide their signature. Preliminary applications received without all 18 year old and over signatures will not be processed. Clear
Should be Empty:

Villages of Taylor Subsidized Housing

How did you hear about us?

Unit Size

Applicant Contact Information

Applicant Household Information

Income

Rental History

Certification and Consent to Release of Information