The Overlook at Elkhorn Creek Apartments

Qualifying Guidelines to Move-In

This property is f i nanced by funds pursuant to Section 42 of the Internal Revenue C o d e . As such, w e are required to fol low

certain guidelines regarding inconne a n d student status.

Must not e x c e e d Annual Income of: 1 person household- $23,750.00 2 person household- $27,150.00 3 person household- $30,550.00 4 person household- $33,900.00 5 person household- $36,650.00 6 person household- $39,350.00

All members of the household c a n n o t b e full-time students Unless, one of the fol lowing exceptions apply :

-Marr ied, filing a joint tax return -Single parent with a d e p e n d e n t chi ld

-Title IV recipient (AFDC) -Part icipant in federal ly f u n d e d j o b training

-Part icipate in Foster Care

R E N T A L A P P L I C A T I O N (Please Print)

Name of Property

Apt. Size Desire: No. o f Bedrooms

Date

Name of Head of Household (Head) Spouse Name (if living with the household)

( ) ( ) Current Address: Street City State Zip Day Phone Night Phone Circle One: Single Married Divorced Separated

Have you ever used another nanne? Y/N_ _. I f so, please indicate name:_

PLEASE ANSWER ALL OUESTIONSt WRITE N/A IF A PARTICULAR QUESTION IS NOT APPLICABLE.

If you need additional space for answers to any paragraph listed below, attach additional sheets and make sure you include a reference to the paragraph number, your name and your Social Security number.

2. FAMILY CP(VIPO$mO^^ Member No. Name(s)

Relation to Head

Date of Birth Mo-Dy-Yr

Social Security No.

Sex (M/F)

Full time Student (Y/N)

1. HEAD

2.

3. 4.

5.

6. Anticipated change in family size? (Y/N) Antic pated change in number o f students? (Y/N)

3. A N T I C I P A T E D I N C O M E : # P R E S E N T E M P L O Y M E N T A N D O T H E R I N C O M E R E C E I V E D B Y H O U S E H O L D M E M B E R S :

Member No. Source of Income: Indicate Name of Source Position From/To Name: 1 $

Address: Phone No.: Contact:

Name; 1 $ Address: Phone No.: Contact:

Are you entitled to child support benefits? • Yes • No Ifyes, do you receive child support benefits? • Yes (Monthly benefit: $ I f no, what attempts are you making to collect the entitled chUd support benefits?

) Q N O

(please explain)

Other sources of income not listed above (e.g. Social Security, alimony, .stipend, etc): Contact, address and phone No.:

Do you have any other income not listed? D Yes D No I f yes, please list source: ^

• An adidt member of the household has no income. List adult members with no Income: Does anyone help you pay your bills? • Yes • No Ifyes, please list ^—. —.

4. ASSEIS: Value

$ $

Has any member of your household sold or otherwise disposed of any asset during the past two years? • Yes • No

S. CREDIT REFERENCES (credit cards, school loans, car payment, mortgage payments, etc.): Account No. Company Name (Creditor) Mon. Pmt. Balance Judgements/Bankruptcy? I f yes, describe

6. BANK REFERENCES: Account No. Bank Name Address

Type of Account Actuallnterest (savings, checking) Average Hal. Earned

• No member of the household has assets.

7. V E m C L E S rincluding company cars, motorcycles, etc.): Name Driver's Lie No. State Model Year Color Car Lie No State Mon. Pmt

8. RESIDENCE HISTORY OF CURRENT AND PREVIOUS L A ^ DLORD:

Current Address Rent/Mo Utilities/Mo Move-in Date Reason for Leaving

Landlord Name Landlord Address Landlord Phone No.

Previous Address Rent/Mo Frora/To Reason for Leaving

landlord Name | Landlord Address Landlord Phone No.

Previous Address Rent/Mo Frora/To Reason for Leaving

Landlord Name Landlord Address ] Landlord Phone No.

9. CHARACTER REFERENCE (Other than Relatives): Name Address Phone No.

10. IN CASE OF EMERGENCY. NOTIFY: Name Address Phone No.

11. SPECIAL NEEDS:

Does anyone in your family have special needs? Yes No Arc special living accommodations required? Yes No Please explain: _

lAVe authorize \3ir'; \l ^ A>SS ~' to verify informationmithis application. I/We further agree that a full disclosure of pertinent facts may be made to y^^iV:VX£JJ to my/our character, general reputation, income, credit and mode of living, I unoerstand tnat this application may be rejected as the result of my/our misrepresentation or insufficient information.

Acceptance of this application and any deposits is not binding upon ^ " ^ t ^ ' ^ ^ ]\Z>'\J>!!)0 until this application is approved in writing.

l/We understand that this application and all related inquiries will be used only for its relevance to screening and occupancy at this property. I/We also understand that this application is for occupancy at a Low Income Housing Tax Credit property and will require annual recertification of my/our household,

SIGNATURE OF A L L PARTIES TO TfflS APPLICATION (18 YEARS OR OLDER):

Applicant Signature (HEAD) Date Property Representative Date

Applicant Signahire (OTHER A D U L T ) Date

T E N A N T R E L E A S E A N D C O N S E N T

I/We , the undersigned hereby, authorize all persons or companies in the categories listed below to release without liability information regarding employment, income and/or a5set$ to "The Overlook at Elkhorn Creek Apartments* for purposes of verifying information on my/our apartment rental application.

I N F O R M A T I O N C O V E R E D

I/We understand that previous or current information regarding me/us may be needed, verifications and inquiries that may be requested include, but are not limited to, personal identity; employment, income and assets; medical or child care allowances. I/We understand that this authorization cannot be used to obtain any information about me/us that Is not pertinent to my/our eligibility for and continued participation as a qualified tenant.

G R O U P S O R I N D I V I D U A L S T H A T M A Y B E A S K E D

The groups or individuals that may be asked to release the above information includes, but are not limited to:

Past and Present Employees Welfare Agencies Veterans Administration Previous Landlords (including State Unemployment Agencies Retirement Systems

Public Housing Agencies) Social Security Administration Banks and Other Financial Support and Alimony Providers Medical and Child Care Providers Institutions

C O N D I T I O N S

I/We agree that a photocopy of this authorization may be used for the purposes stated above. The original of this authorization is on file and will stay In effect for a year and one month from the date signed. l /we understand l/we have a right to review this file and correct any Information that is incorrect.

SIGNATURES

Applicant/Resident Print Name Date

Coapplicant/Resldent Print Name Date

Adult Member Print Name Date

Adult Member Print Name Date

N O T E : THIS GENERAL CONSENT MAY NOT BE USED TO REQUEST A COPY OF A TAX RETURN. IF A COPY OF A TAX RETURN IS NEEDED, IRS FORM 4506, "REQUEST FOR COPY OF TAX FORM," MUST BE PREPARED AND SIGNED SEPARATELY,

W A R N I N G : S e c t i o n 1 0 0 1 o f T i t l e 1 8 o f t h e U . S . C o d e m a k e s I t a c r i m i n a l o f f e n s e t o m a k e w i l l f u l , f a l s e s t a t e m e n t s o f m i s r e p r e s e n t a t i o n t o a n y d e p a r t m e n t o r a g e n c y o f t h e U . S . o r t o a n y m a t t e r w i t h i n I t s J u r i s d i c t i o n .

Rev. 2007