15 Bond Affordable Rental Housing Program First-Come First-Served Application Form 

PROGRAM GUIDELINES

 

15 BOND AFFORDABLE RENTAL HOUSING PROGRAM

FIRST-COME FIRST-SERVED

 

PLEASE READ CAREFULLY

 

 

The Long Island Housing Partnership (LIHP), in cooperation with Namdar Group/14 Park Place LLC (the “Owner”) and the Village of Great Neck Plaza, is pleased to announce that it is accepting First-Come First-Served Applications for one affordable rental unit (the “Affordable Units”) in Village of Great Neck Plaza, New York.  The Affordable Unit is part of a larger rental complex containing 55 units known as “15 Bond”.

 

LIHP is responsible for administering the Application and program qualification process for the Affordable Unit on behalf of the Owner.  Set forth herein are the Program Guidelines with respect to eligibility for the units.  LIHP strictly complies with these Program Guidelines and applicants are urged to read them thoroughly.  Applications will be reviewed for compliance and completeness.  LIHP staff is available to assist with the application, address questions or provide any assistance regarding eligibility.  Final eligibility for tenancy is the determination of the Owner and not LIHP.

 

If you have any questions regarding any of the Program Guidelines, or need any assistance including language assistance such as translation and/or oral interpretation services, please email LIHP at info@lihp.org  before applying.

 

Si tiene alguna pregunta con respecto a cualquiera de las directrices del programa, o necesita cualquier tipo de asistencia, incluida la asistencia lingüística, como la traducción y/o los servicios de interpretación oral, envíe un correo electrónico a LIHP a info@lihp.org antes de solicitaro. Los empleados de LIHP y sus familiares inmediatos no pueden participar en el programa.

 

 Employees of LIHP and their immediate family members are precluded from participating in the program.

 

LIHP IS NEITHER THE LANDLORD, OWNER, MANAGER OR LEASING AGENT.  LIHP’S LIMITED ROLE WILL BE TO INCOME QUALIFY POTENTIAL APPLICANTS. ANY REQUEST FOR A REASONABLE ACCOMMODATION REGARDING ANY UNIT MUST BE CONVEYED TO AND PROCESSED BY THE OWNER/MANAGER.  


SUBMISSION OF REQUIRED DOCUMENTATION OR DETERMINATION OF INCOME ELIGIBILITY DOES NOT GUARANTEE ELIGIBILITY FOR A UNIT.

 

15 BOND RENTAL PROGRAM

 

15 Bond is a 55-unit rental complex containing seven (7) one-bedroom and two-bedroom Affordable Units available to households with incomes that do not exceed 100% of the Nassau/Suffolk area median income (AMI) as determined by HUD and adjusted for household size.  Initial monthly rents are capped at the Fair Market Rent (FMR) for the applicable bedroom size as established by HUD.  Pursuant to the requirements of the Village of Great Neck Plaza, the affordability requirements remain effective for 30 years.

 

Each unit is located in a four (4) story complex complete with elevators and containing an open floor plan with designer kitchens, in-unit washer/dryer units, and a spacious layout with hardwood flooring.  The complex also contains amenities such as high-speed Wi-Fi, keyless entry, 24/7 concierge, on-site management, and indoor and outdoor resident lounges.

 

 MAXIMUM INCOME GUIDELINES

 

One Affordable Unit will be available to households with incomes at or below 100% of the HUD Area Median Income for Nassau/Suffolk Counties (AMI), adjusted for household size.  The 2024 income limits are as follows:

 

                                                                                                100% AMI          

                                                                               1 Bedroom (1-3 Persons)

                                              HOUSEHOLD SIZE                               MAXIMUM ANNUAL INCOME*                

                                                           1                                                              $109,350                                             

                                                           2                                                              $124,950                                             

                                                           3                                                              $140,600                                             

_________________________________________________________________________________

*Includes all income – wages, salary, overtime, bonuses, pensions, social security, 401K distributions, tips, etc.  Your gross income cannot exceed the maximum annual income for your household sizeThe limits above are based on the 2024 HUD “uncapped” income limits.  Income limits are subject to confirmation and adjustment by HUD and may be adjusted for rounding. Income limits are also adjusted annually. **Minimum income guidelines do not apply to those applicants with an approved rental assistance subsidy.  Minimum incomes are set exclusively by the Owner and may not apply if sufficient liquid assets or other mitigating factors and/or guarantees are available as determined and approved solely by the owner.  If the Owner requires a guaranty, please be advised that the Owner may independently verify the income and credit/background of the guarantor and make a determination whether it is acceptable.  The determination as to whether to the guarantor meets the income and credit/background requirements and whether to accept the guaranty is the sole and exclusive determination of the Owner and LIHP has no authority to review, accept or reject a guarantor.  The Owner will determine whether to accept or decline the guarantor and will notify LIHP who will then notify the applicant. Minimum incomes are based on 2x the rent.


ASSET RESTRICTIONS

The Village of Great Neck Plaza requires the following additional standards for eligibility:

  • ·         Households must have net assets (meaning gross assets less liabilities), including assets held in trust, of $150,000 or less
  • ·         During the period of three years before the determination of eligibility, no member of the household shall have transferred assets in excess of $50,000, without fair consideration.


RENTS

The rent for each unit will be capped at the HUD established Fair Market Rent for the applicable size unit.  The HUD Fair Markets Rents are adjusted annually and rents are subject to increase accordingly.  Tenants are responsible for paying all utilities.  The initial rents are set as follows:

 

100% AMI – 1 Bedroom:               $2,144


ANNUAL RECERTIFICATION

The maximum household income requirements are adjusted annually by HUD.  Recertification of income will be required annually to remain eligible for the Program.  To preserve the units for occupants who meet the income and other eligibility guidelines, pursuant to the requirements of the Village of Great Neck Plaza, occupants of the Affordable Units who fail to meet the income or other eligibility requirements will no longer be eligible for the Program and will be required to vacate within 90 days after written notice of loss of eligibility or at the end of the lease term, whichever is later.  Written notice of the loss of eligibility will be sent by express mail or certified mail.


FEES

Additional fees may be imposed by the Owner for such items as a security deposit, credit and background assessments, trash collection, pets, parking, water, renter’s insurance, or other items.  The fees are set exclusively by the Owner and are subject to change by the Owner without notice. 


CREDIT AND BACKGROUND CHECK

The Owner, and/or its agents, will conduct a credit/minimum income and background check on applicants and applicants must meet the Owner requirements. Any determination with respect to credit/minimum income/background rests solely with the Owner and LIHP has no responsibility for such assessments or determinations.


OCCUPANCY/UNIT SELECTION

Unit selection and occupancy requirements are established solely by the Owner and eligible applicants must work directly with the Owner to select a unit.  Any determination with respect to available units or occupancy restrictions rests solely with the Owner and LIHP has no responsibility for such assessments or determinations. 


NO PETS

The Owner does not permit any pets at this development.  Service and/or assistance animals are not subject to the no pet policy.

 

ELIGIBILITY PROCESS

All applicants will be ranked and considered for the program on a first-come, first-served basis.  Eligibility for the Program involves a five-step process.

 

STEP 1:                  Applicant submits a First-Come First-Served Application to LIHP

STEP 2:                  Once your ranking number is reached, LIHP will forward the First-Come First-Served                           Application to Owner

STEP 3:                  Owner conducts a credit/minimum income/background review

STEP 4:                  If approved by Owner, applicant submits a Formal Program Application, together                                                              with required documentation, to LIHP

STEP 5:                  LIHP assesses Program eligibility and, if eligible, applicant works directly with Owner for                                            lease-up



FIRST-COME FIRST-SERVED APPLICATION 

 

First-Come First-Served Applications are available through LIHP’s website at www.lihp.org/rentals.html. First-Come First-Served Applications must be completed and submitted online at www.lihp.org/rentals.html.                            

 

CREDIT/MINIMUM INCOME/BACKGROUND REVIEW

Once your ranking number is reached, LIHP will forward your FCFS Application to the Owner and/or its agents, who will conduct a credit, minimum income and background assessment on the household.  Applicants will be reviewed in the order they are ranked on the Ranked Waitlist.  The credit/minimum income/background checks, and any fee, are performed and required solely by the Owner and/or its agents based upon their internal requirements for tenant occupancy and LIHP is not responsible for the conduct or results of such review.  The Owner and/or its agents will advise LIHP whether the applicant meets the requirements.  LIHP will advise applicants as to their approval or rejection, via email. If an applicant is deemed ineligible, the applicant will be removed from the Ranked Waitlist.


FORMAL PROGRAM APPLICATIONS/INCOME ELIGIBILITY

If an applicant has submitted the First-Come First-Served Application and met the credit/minimum income/ background requirements of the Owner, as an applicant’s name is reached on the Ranked Waitlist, LIHP will send notice to the applicant, by email to submit a Formal Program Application and supporting documents. The notice will contain a link to submit documentation.  LIHP will provide the applicant with a Checklist of required documentation.  The Formal Program Application and required documentation must be completed and received by LIHP within seven (7) calendar days of the notice date.  If the Formal Program Application is not received within such 7-day period, the applicant will be deemed ineligible, with no right of appeal.  If required documentation is missing, LIHP will provide applicant notice, by email, of what is missing and applicant will be required to submit such documentation within three (3) calendar days of the notice date.  If all the documentation is not received within such three (3) day period, the applicant will be deemed ineligible, with a right of appeal. 

 

LIHP will then conduct an income and eligibility review to determine if the applicant meets all Program Guidelines.  If an applicant meets the eligibility requirements, LIHP will provide notice, by email  to the applicant and the Owner advising them of the applicant’s eligibility.  The applicant will then work directly with the Owner to select a unit and execute a lease.  If the applicant does not comply with the Owner requirements for lease execution, the Owner will advise LIHP and LIHP will send notice to the applicant by email , that the applicant is no longer eligible for the program.  Should the applicant be deemed ineligible, LIHP will move on to the next name on the Waitlist, with no right of appeal. 


APPEALS

Under some circumstances as provided herein, applicants who are deemed ineligible may appeal the determination by submitting a request to LIHP. The appeal request must be in writing and must be received (together will all documentation) by LIHP within three (3) calendar days of the date of LIHP’s notice to applicant of the determination of ineligibility. The appeal must state the basis of the appeal and contain documentation to support the appeal. Please note that, if the applicant was deemed ineligible due to failure to submit required documentation within the required time frame, then, no appeal will be granted unless the applicant submits the remaining required documentation with the appeal request within the timeframe required. The appeal will be promptly reviewed and the applicant advised of the final determination by email. Notice to LIHP of an appeal request can ONLY be submitted via a file-specific link that will be provided by LIHP.

 

PROCEDURE TO PROMOTE FAIR AND EQUITABLE WAITLIST PROCESS

First-Come First-Served Waitlist: To be included and ranked on a waitlist, applicants will only be permitted to submit one application or intake form, as applicable.  To this end, LIHP will endeavor, but is not required to, review all submissions. If it appears that an applicant has submitted more than one application or intake form, then LIHP may reject the additional subsequent submission(s) and the applicant will retain the earliest ranking number.  Items to be reviewed include, but are not limited to, (1) submissions from the same address; (2) submissions that list the same household members; (3) submissions that list the same names but with different addresses; (4) submissions that utilize the same email address; (5) submissions that utilize the same phone numbers (home and cell); and (6) such other items as may be determined in LIHP’s sole discretion.


General Provisions:


LIHP may contact the applicant regarding any uncertainty as to whether more than one application or intake form has been submitted.  LIHP may rely upon such certifications, documentation or other information as it deems reasonable, in its sole discretion, in assessing whether more than one submission has been made. If LIHP, in its sole discretion, determines that a submission is to be rejected, LIHP may, but is not required to, notify the applicant of same.  The Program Guidelines advise applicants of the above and, accordingly, applicants have prior notice of such procedures. Nothing herein shall preclude more than one application from the same address provided the applicants will not be part of the same household for purposes of the program applied for.  LIHP makes no guarantee that each duplicate will have been identified and removed from the program.  


FAIR HOUSING AND NON-DISCRIMINATION

LIHP is committed to furthering and promoting fair housing, equal opportunity, and non-discrimination in compliance with all federal, state and local laws, including, but not limited to, the Fair Housing Act, as amended by the Housing for Older Americans Act, the Americans with Disabilities Act, the Civil Rights Act, and the New York State Human Rights Law.  The LIHP staff is available to assist with the application, and answer questions about eligibility requirements.  In furtherance of this policy, LIHP shall not discriminate on the basis of race, creed, color, national or ethnic origin, sex, sexual orientation, gender identity, familial status, source of income, religion, disability, veterans’ status, age, or any other basis prohibited by law.


LIMITED ENGLISH PROFICIENCY AND ACCOMMODATIONS

 LIHP will take reasonable steps to ensure that persons with Limited English Proficiency (LEP) and persons, who need assistance or who have a limited ability to speak, read, or write English, will have meaningful access and an equal opportunity to participate in the Program.  Interpreters, translators and other aids needed to comply with this policy shall be provided as reasonably necessary.  If you have any questions regarding the guidelines, or need assistance including language assistance such as translation and/or oral interpretation services, please contact the LIHP at info@lihp.org.

 

DISCLAIMER OF LIABILITY/RELEASE

APPLICANT ACKNOWLEDGES THAT LIHP IS NEITHER THE OWNER, MANAGER, LANDLORD OR LEASING AGENT.  LIHP’S ROLE IS LIMITED TO REVIEWING YOUR HOUSEHOLD INCOME TO DETERMINE IF YOU MEET THE MAXIMUM INCOME QUALIFICATIONS FOR THE PROGRAM. THE COMPLEX IS/WAS CONSTRUCTED AND IS OPERATED INDEPENDENTLY BY THE OWNER/MANAGER AS LANDLORD AND LIHP HAS NO ROLE IN UNIT OCCUPANCY, UNIT SELECTION, REVIEW OF YOUR SUITABILITY FOR TENANCY, FEES ASSESSED, THE LEASE TERMS, THE LEASE-UP PROCESS BY OWNER/MANAGER, THEIR AFFILIATES OR AGENTS, PROCESSING OF ANY HOUSING VOUCHER, UNIT LAYOUT AND LOCATION, OR THE OPERATIONS, STATEMENTS, ACTS OR OMMISSIONS, AND POLICIES/PROCEDURES, OF THE COMPLEX OR THE OWNER/MANAGER AND ITS AFFILIATES OR AGENTS WHATSOEVER, INCLUDING, WITHOUT LIMITATION, IN CONNECTION WITH ANY REQUEST FOR REASONABLE ACCOMMODATION (THE “OWNER RESPONSIBILITIES”). WITHOUT LIMITING THE FOREGOING, YOU ACKNOWELDGE THAT LIHP HAS NO ABILITY OR RESPONSIBILITY TO ADDRESS ANY REQUEST YOU MAY HAVE FOR A REASONABLE ACCOMMODATION/MODIFICATION REGARDING A UNIT AND ANY SUCH REQUEST WILL BE MADE BY YOU DIRECTLY TO THE OWNER/MANAGER FOR PROCESSING. 

ACCORDINGLY, YOU AGREE THAT LIHP, ITS AFFILIATES, EMPLOYEES, AGENTS, OFFICERS, MEMBERS, AND DIRECTORS (COLLECTIVELY, “LIHP”) ARE NOT LIABLE FOR ANY CLAIMS OR CAUSES OF ACTIONS ARISING FROM ANY OF THE OWNER/MANAGER RESPONSIBILITIES AND, FOR GOOD AND VALUABLE CONSIDERATION, YOU HEREBY RELEASE AND WAIVE ALL CLAIMS OR CAUSES OF ACTION YOU NOW HAVE OR MAY HAVE AGAINST LIHP ARISING OUT OF OR RELATED TO THE OWNER RESPONSIBILITIES.

YOU HAVE READ THIS DOCUMENT, UNDERSTAND THAT YOU MAY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. IF ANY PROVISION OF THIS DOCUMENT IS UNENFORCEABLE, IT SHALL BE MODIFIED TO THE EXTENT NECESSARY TO MAKE THE PROVISION VALID AND BINDING, AND THE REMAINDER OF THIS DOCUMENT SHALL REMAIN ENFORCEABLE TO THE FULL EXTENT ALLOWED BY LAW.

 

                        ****************************************************************

Disclaimer: It is understood that this is not an offer and that the processes, terms and conditions may be changed at any time by the Long Island Housing Partnership, Inc., and Affiliates.  It is further understood that notices by the Long Island Housing Partnership, Inc., and Affiliates may be made in such manner as Long Island Housing Partnership, Inc., and Affiliates may determine, including solely by email or advertisement.

Applicant
By checking acceptance below, I certify that I have read and understand the Program Guidelines.



THIS FORM MUST BE COMPLETED AND SIGNED BY
 EACH OCCUPANT OVER THE AGE OF 18.

*ADDITIONAL HOUSEHOLD MEMBERS UNDER THE AGE OF 18 MUST PROVIDE NAME & SS# ONLY
  

One Bedroom 100% AMI
APPLICANT











Your Vehicle




Driver's License



Applicant Residence Information:







Email Verification



Dates of Residency






Applicant Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


Applicant

ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 




FIRST ADDITIONAL HOUSEHOLD MEMBER

















Your Vehicle




Driver's License



Residence Information:









Dates of Residency






Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


First Household Member

ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 




SECOND ADDITIONAL HOUSEHOLD MEMBER

















Your Vehicle




Driver's License



Residence Information:









Dates of Residency






Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


Second Household Member

                                                                                ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 




THIRD ADDITIONAL HOUSEHOLD MEMBER

















Your Vehicle




Driver's License



Residence Information:









Dates of Residency






Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


Third Household Member

ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 




FOURTH ADDITIONAL HOUSEHOLD MEMBER

















Your Vehicle




Driver's License



Residence Information:









Dates of Residency






Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


Fourth Household Member

ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 




FIFTH ADDITIONAL HOUSEHOLD MEMBER

















Your Vehicle




Driver's License



Residence Information:









Dates of Residency






Employment Information/Additional Income:











Dates of Employment


If there are other sources of income you would like us to consider such as social security, pension, etc., please list source and income amount.


Fifth Household Member

ACKNOWLEDGEMENT

By signing this First-Come, First-Served Application, you certify (1) that you have read and understand the Program Guidelines, (2) that all intended occupants over the age of 18 years of age have completed and signed this Application, and (3) that each such occupant of the Apartment will sign the Lease at the time required by 14 Park Place LLC, their affiliates, property managers, employees, or agents (the "Owner/Manager"), if you are deemed eligible.

 

You authorize Owner/Manager, themselves or through its designated affiliates, agent or employees, to obtain a Consumer Report and (1) conduct a background search on you which will include, but not be limited to, a credit and criminal records check, and (2) obtain and verify all income, employment, credit,  and related information,  for the purpose of determining whether or not to lease the Apartment to you.  You understand that should you enter into the Lease for the Apartment, Owner/Manager and their designated affiliates, agents and employees will have a continuing right to review your credit information, rental application, and related information, for account review purposes and for improving application methods.

 

By signing this Application, you certify that all information contained in this Application is true, correct and complete.  You agree, and it is your intent, to sign this record/document by inserting/typing your name below and by electronically submitting this record/document. You understand that by signing and submitting this record/document in this fashion, you are affirming the truth of the statements contained therein and that it is the legal equivalent of having placed your handwritten signature on the submitted record/document and all parties may rely on same.

 

It is unlawful to discriminate against an applicant or tenant because of their race, color, national origin, source of income, religion, gender, familial status, disability, or any other basis that may be protected under applicable state or local law. 





EACH OCCUPANT OVER 18 YEARS OF AGE MUST COMPLETE AND SIGN THIS FORM.

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