Application & Questionnaire
Low Income Housing Tax Credit Program. Complete all requested information before submitting.
Household Members
Complete for each household member who will occupy the unit at time of move-in.
Questionnaire
Answer Yes or No to each question.
Residence History
List the past three years of housing references.
Personal References
List a personal reference other than a relative.
Emergency Contact
If possible, list someone in the area that is not listed on the application.
Income Information
Include all income anticipated for the next 12 months. Include all dollar amounts and check Yes or No to each question.
Asset Information
Include all assets held by all household members, including minors, and any income derived from each asset.
Student Information
If yes, student must continue with the following questions and provide verification for all yes answers.
Section 8 Rental Assistance
Signature Clause
All questions answered Yes will be verified through the appropriate third-party source. It is your responsibility to provide management with the necessary information to process this application and verify eligibility. I understand that management is relying on this information to prove my household eligibility for the Low Income Housing Tax Credit Program. I certify that all information and answers are true and complete to the best of my knowledge. I consent to release the necessary information to determine my eligibility. I understand that false information or false statements may be grounds for denial and may result in criminal penalties. My occupancy is contingent on meeting resident selection criteria and Low Income Housing Tax Credit Program requirements. All adult household members must sign below.
Self-Affidavit
You have applied to live in an apartment governed by the federal Housing Credit Program. The program requires certification of income, assets, and eligibility information before eligibility is granted and each subsequent year you remain in the unit.
Tenant Release and Consent
I/we authorize all persons or companies listed below to release without liability information regarding employment, income, and/or assets to the owner or agent for verifying information on my/our apartment rental application. I/we understand that previous or current information may be needed, including personal identity, employment, income, assets, and medical or childcare allowances. This authorization cannot be used to obtain information that is not pertinent to eligibility or continued participation as a qualified tenant.
