E’Port Family Homes Apartments 158-168 First Street

200-214 Third Street Elizabeth, NJ 07206

THIS PRE- APPLICATION IS FOR E’PORT FAMILY HOMES WE HAVE TWO LOCATIONS OPENING IN JUNE 2021 AND AUGUST 2021

Pre-Applications will be processed based upon income, family size, and eligibility determined under the Low-Income Housing Tax Credit Program.

APPLICANTS MUST MEET ALL CURRENT AND FUTURE INCOME AND OCCUPANCY

ELIGIBILITY CRITERIA

Applications will be accepted by mail/ postmarked or in person at the address below between the dates of May 20th to May 26th 2021.

No applications will be accepted after May 26, 2021

HOUSING AUTHORITY OF THE CITY OF ELIZABETH 205 FIRST STREET

ELIZABETH, NJ 07206 PHONE NUMBER (908) 355-4155

Only one application per household will be accepted

Applications will be marked in a numerical sequence by the date and time they are

received Eligible applicants will be placed on the waiting list for this development

Applications will be processed on a first come-first served basis

Unit Size Monthly Rent Maximum Income for Family Size

1 Bd $1,102.00 1 Person 2 Person 3 Person 4 Person

2 Bd $1,307.00 $45,120.00 $51,600.00 $58,020.00 $64,440.00

E’Port Family Homes Urban Renewal LP

Pre-Application for Housing

Elizabeth, NJ 07206

Phone: 908-355-4155

This is a pre-application for housing with: E’Port Family Homes Urban Renewal LP, Elizabeth, New Jersey 07206

Please complete this pre-application and return to:

Housing Authority of the City of Elizabeth

ATTN: E’Port Family Homes Urban Renewal L.P. 205 First Street, Elizabeth, NJ 07206

A. General Information

Applicant Name:

Address:

Street Apt. City State Zip

Daytime Phone: Evening Phone:

Bedroom size requested: □ One Bedroom □ Two Bedrooms

Building Preference: □ 158-168 First Street □ 200-214 Third Street (Please choose one or both)

Do you receive rental assistance? (Section 8, TBRA, or any other type of assistance) □ Yes □ No

The following information is requested by the apartment owner in order to assure the Federal government that Federal laws

prohibiting discrimination against tenant applicants on the basis of race, national origin, familial status, handicap/disability and sex

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. However, if you choose not to furnish it, the owner is required

to note the race/national origin and sex of individual applicants on the basis of visual observation or surname.

Please check: □ Caucasian □ African American □ Asian □ Hispanic □ Other__________________________

B. Household Composition

List ALL persons who will live in the apartment. List the Head of the Household first.

Name Relationship to

Head

Marital

Status

Birth

Date

Age SS# Student

Y/N

1.

2.

3,

4,

Do you anticipate any additions to the household in the next twelve months? □Yes □ No

If yes, explain;

C. Income: List ALL sources of income as requested below. If a section does not apply, cross it out or write N/A

D. Assets: List ALL assets as requested below. If a section does not apply, cross it out or write N/A

Insert Household member’s name Source of Income Gross Monthly Amount Employment

Social Security

SSI Benefits

Pension (list source)

Veteran's Benefit

Unemployment Compensation

TANF

Child Support

Self-employment

Do you anticipate any changes in the next 12 twelve months? □ Yes □ No

If yes, explain:

Checking Account # Bank Balance $

Checking Account # Bank Balance $

Savings Account # Bank Balance $

Savings Account # Bank Balance $

Retirement Account # Bank Balance $

Certificates of Deposit # Bank Balance $

Prepaid Debit Card # Bank Balance $

Life Insurance Policy # Maturity Date: Value $

Real Estate Property Do You Own Any Property □ Yes □ No

If yes, type of property

D. Assets Continued

E. Additional Information

Have you disposed of any other assets in the last 2 years?

(Example, Give away money to relatives) □ Yes □ No

If yes, describe the asset

Date of disposition Do you have any other assets not listed above (For example, personal property)? □ Yes □ No

If yes, please list:

Mutual Funds Name: #Shares: Interest or Dividend$ Value$

Stocks #Shares: Interest or Dividend $ Value$

Bonds #Shares: Interest or Dividend$ Value$

Investment

Property

Appraised Value$

Have you or any member of your household ever been convicted of a felony? □ Yes □ No

If yes, describe:

Have you or any member of your household ever been evicted? □ Yes □ No

If yes, describe:

Are you or any member of your household subject to a lifetime registration requirement under a state Sex Offender registration in any state?

□ Yes □ No

If yes, which state?

If yes describe:

Do you Own a Vehicle □ Yes □ No

Type of Vehicle: License Plate:

Year/Make: Color:

Do you own any pets? □ Yes □ No

If yes, describe:

Certification

If accepted, I/We certify this apartment will be my/our sole residence. I/We understand that my eligibility for housing will be based on

applicable income limits and by management's selection criteria. This application creates no obligation for the Landlord or the applicant.

Upon receipt of this application, income eligibility will be determined as well as a credit check. Income and assets will be verified. I/We

understand that I/We must pay a security deposit for this apartment prior to occupancy. I/We certify that all information in this application is

true to the best of my/our knowledge and I/We understand that false statements of information is punishable by law and will lead to cancellation

of this application or termination of tenancy after occupancy. All adult applicants, 18 or older, must sign application. All information is

confidential.

Authorization

I understand that in conjunction with my application for tenancy, E’Port Family Homes Urban Renewal LP and The Housing Authority of the

City of Elizabeth may use the services of an outside agency to research and verify the information I have provided on my application for housing

including my personal background, work history and qualifications. I therefore authorize E’Port Family Homes Urban Renewal LP and The

Housing Authority of the City of Elizabeth (or any authorized entity hired for this purpose) to verify any information provided by me in this

tenancy application and any supplemental attachments, including but not limited to: criminal conviction record, current and former employers,

credit reports, and personal references. I agree, authorize and consent to the release and disclosure of any and all information including but not

limited to the above to E’Port Family Homes Urban Renewal LP, The Housing Authority of the City of Elizabeth and any authorized reporting

agency. I further agree, authorize and consent to E’Port Family Homes Urban Renewal LP and The Housing Authority of the City of Elizabeth

to obtain a consumer report as well as a criminal and sexual offender report from NTN Screening Reports (or any other entity hired for this

purpose) and/or investigative consumer report, which may contain information about my credit worthiness, credit standing, credit capacity, and

criminal background. In accordance with the Fair Credit Reporting Act, I will be notified by E’Port Family Homes Urban Renewal LP and/or

The Housing Authority of the City of Elizabeth If my tenancy is denied because of information obtained from a consumer reporting agency. I

further understand that I may request a copy of the report from the consumer reporting agency having conducted the background investigation.

By signing this application, I hereby expressly release E’Port Family Homes Urban Renewal LP and The Housing Authority of the City of

Elizabeth and any agent, procurer or furnisher of information, from any liability what‐so‐ever in the use, procurement, or furnishing of such

information, and understand that my application information may be provided to various local, state and/or federal government agencies,

including without limitation, various law enforcement agencies.

Signatures:

Signature a/Tenant Date

Signature of Co-Tenant Date

Signature of Co-Tenant Date

Signature of Co-Tenant Date