waitlist application checklist · waitlist application checklist ... ultimo talón de cheque mas...

Rev. 01/25/2010

NAPA PARK HOMES 790 Lincoln Avenue, Napa, CA 94558

707-255-3119 Professionally Managed by Napa Valley Community Housing since 2005

Waitlist Application Checklist

Thank you for your interest in Napa Park Homes rental housing. For your convenience we’ve summarized below the items you must bring when you submit your waitlist application. Applications cannot be accepted until all items, applicable to your household, are present. This means that every form must be completed in full and required documents provided. Thank you!

Completed and Signed Waitlist Application. Completed and signed Race and Ethnicity forms, one per household. Most recent Pay Check Stub for all applicants’ who are working or receiving

unemployment. Note: If pay amounts vary from one pay period to the next, it is advisable to provide more than one pay stub.

State or National photo ID for each adult household member. Current Social Security, SDI or SSI award letter, if anyone in the

household is receiving benefits Current EDD or other benefit letter, if anyone in the household is receiving

Unemployment, Disability or Workers Compensation. Current Passport to Services letter, if receiving public assistance (TANF,

food stamps, etc.)

EQUAL OPPORTUNITY HOUSING

Napa Valley Community Housing 5 Financial Plaza, Suite 200

Napa, CA 94558 www.nvch.org

Rev. 01/25/2010

NAPA PARK HOMES 790 Lincoln Avenue, Napa, CA 94558

707-255-3119 Manejados Profesionalmente por Napa Valley Community Housing desde el 2005

Lista de documentos para la solicitud de lista de espera

Gracias por su interés en aplicar a los departamentos Napa Park Homes. Para su comodidad enseguida hemos resumido los artículos que necesita traer cuando presente su solicitud. No se aceptaran solicitudes incompletas. Esto significa que cada uno de los formularios tienen que ser llenados completamente y todos los documentos requeridos sean proveídos a la hora de entrega. ¡Gracias!

Solicitud para la lista de espera completada y firmada. Formulario completado de raza y grupo étnico, llenar un formulario por hogar. Ultimo talón de cheque mas reciente para todos los solicitantes con empleo o

que reciben desempleo. Nota: Si el total de paga varea de fecha de pago a fecha de pago se les recomienda traer más de un talón de cheque.

Identificación Estatal o Nacional con foto para cada uno de los adultos miembros de familia.

Carta actual de pagos del seguro social, SDI o SSI si alguien en la familia recibe estos beneficios

Carta del EDD actual u otra carta de beneficios si alguien in la casa recibe Desempleo, Discapacidad o Compensación de Trabajadores.

Pasaporte o carta de servicios actual si usted recibe ayuda pública (TANF, estampillas de comida, etc.)

EQUAL OPPORTUNITY HOUSING

Napa Valley Community Housing 5 Financial Plaza, Suite 200

Napa, CA 94558 www.nvch.org

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NAPA PARK HOMES, INC. 790 Lincoln Avenue, Napa, CA 94558

APPLICATION FOR WAITING LIST

OFFICE USE ONLY ONE / TWO / THREE

Please complete all sections by printing in ink. DO NOT LEAVE ANY SECTION BLANK. If it does not apply, write “N/A.” Extra space is provided on the back. Thank you APPLICANT/Last Name (Head of Household) First Name Middle Initial Driver’s License/I.D.#

SPOUSE (CO-TENANT)/Last Name First Name Middle Initial Driver’s License/I.D.#

Present Address/Street No. City, State, Zip Length of Residence Phone Number

( )

TENANT HISTORY (Five [5] years minimum) Address

City

State

Length of Stay

Landlord Name/Phone

HOUSEHOLD COMPOSITION: List all persons, including yourself, who will reside in the unit. Note: The number to the left indicates the “Household Member Number” and is the number requested to indicate a particular household member in the remaining sections of this application.

#

Full Name

Relationship to Head

Sex (Circle one)

Age Birthdate Birthplace/ (U.S. City or Foreign)

Occupation Social Security or Alien Registration #

1 Head of Household

M F

2 M F

3 M F

4 M F

5 M F

6 M F

7 M F

INCOME * EMPLOYMENT ONLY: List all full-time, part-time and/or seasonal employment for EACH household member, including self-employment earnings. Include Overtime Pay, Tips and Bonuses. (If you have income from “other” sources, see next page.) HH Member #

Place of Employment

Employment Address (Including Zip code)

Employer Phone

Name of Supervisor

Annual Income (Yearly Total)

NAPA PARK HOMES, INC. 790 Lincoln Avenue, Napa, CA 94558

USO DE OFICINA SOLAMENTE UNA / DOS / TRES

APLICACION PARA LA LISTA DE ESPERA

Por favor complete todas las secciones con tinta. NO DEJE NINGUN ESPACIO EN BLANCO. Si alguna información no le aplica escriba “N/A”. Espacio adicional proporcionado al reverso. Gracias SOLICITANTE/Apellido (Cabeza del Hogar) Primer Nombre Inicial de Segundo

Nombre # de Licencia de Conducir/I.D.

ESPOSA(O)/(CO-ARRENDANTE) – Apellido Primer Nombre Inicial de Segundo Nombre

# de Licencia de Conducir/I.D.

Dirección actual/ No. de calle Ciudad, Estado, Código Duración de Arriendo

Número de Teléfono ( )

HISTORIAL DE ARRENDAMIENTO (Mínimo 5 años) Dirección Ciudad

Estado

Tiempo de Estancia

Nombre del Dueño/Teléfono

COMPOSICION DEL HOGAR: Escriba todas las personas, incluyéndose usted mismo, que vivirán en la unidad. Nota: El número de la izquierda indica el “Número de Miembro del Hogar” y es el número requerido para indicar miembros del Hogar en particular en las siguientes secciones de esta aplicación.

#

Nombre Completo

Relación con el Cabeza de Hogar

Sexo (Circule uno)

Edad Fecha de Nacimiento

Lugar de Nacimiento (EE.UU., o Extranjero)

Ocupación # Seguro Social o Registración Extranjera

1 Cabeza del Hogar

M F

2 M F

3 M F

4 M F

5 M F

6 M F

7 M F

INGRESOS * EMPLEO SOLAMENTE: Escriba todos los empleos de tiempo completo, tiempo parcial y/o temporal para TODOS los miembros del hogar incluyendo ingresos de negocio propio. Incluya horas extras, propinas, y bonos. (Si tiene ingresos de “otras” fuentes, vea la página siguiente.) # Miembro del Hogar

Lugar de Empleo

Dirección de Empleo (Incluyendo Código Postal)

Teléfono de Empleador

Nombre de Supervisor

Ingreso Anual (Total al Año)

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$

$

$

$

PREFERENCES: To indicate that your household qualifies for one of the Preferences established for this property, check the applicable box below.

My household has been displaced from housing by government action. My household has been displaced from housing due to a presidentally declared disaster.

INCOME FROM OTHER SOURCES: Please list ALL income from sources other than “employment” for ALL family members. This Includes but is not limited to, Welfare, TANF, Social Security, SSI, SDI or other Disability, Death Benefits, Unemployment, Alimony, Child Support, etc. HH Member Annual Income Number Source of Income Address of Source (Yearly Total)

$

$

$

CHECKING ACCOUNTS: HH Member Current Interest Number Account Number Bank Name Complete Bank Address Balance Rate

$

%

$

%

$

%

SAVINGS ACCOUNTS: HH Member Current Interest Number Account Number Bank Name Complete Bank Address Balance Rate

$

%

$

%

$

%

STOCKS, BONDS, CREDIT UNION SHARES, ETC.: HH Member Current Annual Number Description of Asset Value From this Asset

REAL ESTATE: DO YOU OWN REAL ESTATE? Yes No If Yes, are you receiving any income from this property? Yes No

If Yes, ADDRESS OF PROPERTY:

Annual INCOME from this Property: $ EXPENSES (type/amount):

MEDICAL AND/OR CHILD CARE EXPENSES:

CHECK IF HEAD OF HOUSEHOLD OR SPOUSE IS: 1) Handicapped ( ) 2) Disabled ( ) 3) Age 62 or Older ( )

If you checked box 1, 2, or 3 above, please list below out-of-pocket medical expenses not covered by Insurance here:

DO YOU INCUR CHILDCARE OR DISABLED ADULT CARE COST/S? Yes ( ) No ( )

ARE ALL ADULT FAMILY MEMBERS EITHER WORKING, STUDYING OR SEEKING EMPLOYMENT? Yes ( ) No ( )

If you answered “Yes” to the above two (2) questions, please list payments made to childcare provider below.

HH Member Cost per Number Description of Expense/s Paid To Address Month

$

$

$

$

$

$

# Miembro Ingreso AnualDel Hogar Fuente de Ingreso Dirección (Total al Año)

# Miembro Costo PorDel Hogar Descripción de Gasto/s Pagado a Dirección Mes

PREFERENCIAS: Para indicar que su hogar califica para una de las Preferencias establecidas para esta propiedad, marque la caja correspondiente abajo.

Mi Hogar ha sido desplazado de vivienda debido a acción gubernamental. Mi Hogar ha sido desplazado de vivienda debido a desastres declarados presidencialmente.

INGRESOS DE OTRAS FUENTES: Por favor anote TODOS los ingresos de otras fuentes aparte de “empleo” de TODOS los miembros del hogar. Esto incluye pero no está limitado a “Welfare”, TANF(asistencia pública), Seguro Social, SSI, SDI o Discapacidad, Beneficios por Muerte, Desempleo, Manutención de Cónyuge, Manutención de niños, etc.

$

$

$

CUENTAS DE CHEQUES: # Miembro Balance Tasa de Del Hogar Número de Cuenta Nombre del Banco Dirección completa del Banco Actual Interés

$

%

$

%

$

%

CUENTAS DE AHORROS: # Miembro Balance Tasa de Del Hogar Número de Cuenta Nombre del Banco Dirección completa del Banco Actual Interés

$

%

$

%

$

%

ACCIONES, BONOS FINANCIEROS, ACCIONES DE UNION DE CREDITO, ETC.: # Miembro Valor Ingreso AnualDel Hogar Descripción de los Bienes Actual de esta Acción

BIENES RAICES: ES DUEÑO DE BIENES RAICES? Si No si contesto Sí, ¿Está recibiendo algún ingreso por esta propiedad? Si No

Si, Sí, DIRECCION DE LA PROPIEDAD:

INGRESO Anual de esta Propiedad: $ GASTOS (tipo/cantidad):

GASTOS MEDICOS Y/O DE CUIDADO DE NIÑOS:

MARQUE SI EL CABEZA DEL HOGAR O ESPOSA(O) ES: 1) Discapacitado( ) 2) Incapacitado( ) 3) Mayor de 62 años( )

Si marcó opciones 1,2 ó 3 arriba, por favor escriba abajo gastos médicos no cubiertos por aseguranza y que usted paga de su bolsillo:

¿TIENE GASTOS DE CUIDADO DE NIÑOS O DE ADULTO DISCAPACITADO? Si ( ) No ( ) ¿ESTAN TODOS LOS ADULTOS MIEMBROS DEL HOGAR TRABAJANDO, ESTUDIANDO, O BUSCANDO EMPLEO? Si ( ) No ( )

Si contestó “Si” a las dos preguntas de arriba, por favor escriba abajo los pagos que hace al proveedor de cuidado.

$

$

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1. Have you sold or given away any assets in the last two years for less than its fair market value? 2. Have you ever been evicted from tenancy? 3. Have you ever been terminated from a housing program because of fraud, non-payment of rent or failure to

[ [ [

] Yes* ] Yes* ] Yes*

[ [ [

] No [1]

] No [2]

] No [3]comply with a recertification process?

4. Has any adult in your household filed for bankruptcy in the last three years?

[

] Yes*

[

] No [4]

5. Does your household have debts of more than $6,000 which are currently in collection? [ ] Yes* [ ] No [5]

manufacture or sale of illegal drugs or domestic violence) [ ] Yes* [ ] No [6]

7. Have you ever-applied to live at this property before? [ ] Yes* [ ] No [7]

8. Is at least one member of your household a U.S. citizen or qualify as a U.S. legal Non-citizen? [ ] Yes* [ ] No [8]

9. Does anyone in your household need a unit with special features intended for persons with disabilities? [ ] Yes* [ ] No [9]

AUTOMOBILE / VEHICLE: List ALL motor vehicles owned by/registered to a family member. (Include Motorcycles) HH Member Number Name of Registered Owner Model/Make Year License Plate Number State Color

Please indicate your answers to the following questions:

6. Has any member of your household been convicted of a crime in the last five (5) years? (Including the use

(No applicant, who is otherwise qualified, will be denied housing solely by reason of his/her disability)

Describe special features required

10. Do you anticipate any changes in your household size in the next twelve months? [ ] Yes* [ ] No [10]

11. Are any members of this household full-time students? List HH Members #’s 12. How/Where did you hear about this housing facility?

*Explain any “Yes” answers here:

PLEASE NOTE: THIS IS A PRELIMIARY APPLICATION AND GIVES NO LEASE OR RENTAL RIGHTS. ADDITIONAL INFORMATION WILL BE REQUIRED AT A LATER DATE TO COMPLETE PROCESSING WHEN THE WAITLIST APPLICANT IS INVITED TO APPLY FOR A VACANT UNIT. WAITLIST APPLICANTS MUST UPDATE THEIR APPLICATION BY COMPLETING AND RETURNING A WAITLIST UPDATE FORM EVERY SIX MONTHS IN ORDER TO REMAIN ON THE LIST.

GROUNDS FOR DENIAL: An explanation of our Grounds for Denial for Housing Applications can be found within the attached Tenant Selection Plan, pgs. 10-11. Please acknowledge here that you have received a copy of the T.S.P. and located these reason for possible rejection. _

Initials, Head of Household

APPLICANT CERTIFICATION: I/We certify that if I/We were selected to move into this project, the unit would be my/our only place of residence. I/We understand that the above information is being collected to make a preliminary determination of my/our eligibility for subsidized housing. I/We certify that the statements made in this application are true and correct to the best of my/our knowledge and belief. I/We understand that false statements of information are punishable under Federal Law.

Head of Household Date Spouse/Co-Tenant Date

Other Adult Household Member Date Other Adult Household Member Date

Other Adult Household Member Date Other Adult Household Member Date

Received By: Date: Time:

Residency at Napa Park Homes is open to all eligible, qualified persons without regard to race, color, religion, national origin, age, disability, sex,

familial status, ancestry, or sexual orientation.

AUTOMOVIL/VEHICULO: Anote TODOS los vehículos propios/registrados de los miembros del Hogar. (Incluya Motocicletas) # Miembro Del Hogar Nombre del Dueño Registrado Modelo/Marca Año No. de Placa Estado Color

Por favor indique sus respuestas a las siguientes preguntas:

1. ¿Ha vendido o regalado alguna acción en los últimos dos años por menos del valor justo del mercado? 2. ¿Ha sido desalojado de alguna vivienda?

[ [

] Si* ] Si*

[ [

] No [[1]

] No [2]3. ¿Ha sido alguna vez terminado de algún programa de vivienda debido a fraude, incumplimiento con el pago de renta o incumplimiento con el proceso de re-certificación? [ ] Si* [ ] No [3]

4. ¿Algún adulto en el hogar se ha declarado en banca rota en los últimos 3 años? 5. ¿Alguien en su hogar tiene deudas de mas de $6,000 las cuales actualmente están en colección? 6. ¿Alguien en su hogar ha sido convicto de algún crimen en los últimos cinco (5) años? (Incluyendo el uso,o venta

[ [

] Si* ] Si *

[ [

] No [4]

] No [5]

de drogas ilegales o violencia doméstica).

7¿Ha aplicado para vivir en esta propiedad anteriormente? 8. ¿Es al menos uno de los miembros del hogar ciudadano de los EE.UU. ó califica como no-ciudadano legal de

[ [

] Si * ] Si *

[ [

] No [6]

] No [7]

EE.UU? 9. ¿Alguien en su hogar requiere adaptaciones especiales previstas para una persona con discapacidades?

Ningún solicitante, que de cualquier otra manera califique, se le negará vivienda por el solo hecho de su discapacidad)

[ [

] Si * ] Si *

[ [

] No [8]

] No [9]

Describa las adaptaciones especiales requeridas 10. ¿Anticipa cambios en el tamaño de su hogar en los próximos 12 meses? [ ] Si * [ ] No [10]

11. ¿Hay algunos miembros de este hogar estudiantes de tiempo completo? Escriba el # de Miembro/(s) 12. ¿Cómo/Dónde escuchó de esta facilidad de vivienda?

*Explíque cualquier respuesta contestada “Si" en este espacio:

POR FAVOR NOTE: ESTA ES UNA APLICACION PRELIMINARIA QUE NO DA DERECHOS A CONTRATO O ARRENDAMIENTO. INFORMACIÓN ADICIONAL SERÁ REQUERIDA DESPUES PARA COMPLETAR EL PROCESO CUANDO EL APLICANTE SEA INVITADO A APLICAR PARA UNA UNIDAD VACANTE. SOLICITANTES DE LA LISTA DE ESPERA DEBEN ACTUALIZAR SU APLICACIÓN AL COMPLETAR Y REGRESAR LA FORMA DE VERIFICACION DE ESTATUS DE APLICACIÓN CADA SEIS MESES EN ORDEN DE MANTENERSE EN LA LISTA DE ESPERA.

FUNDAMENTOS PARA LA DENEGACIÓN: Una explicación de nuestros fundamentos para la denegación de la solicitud de arrendamiento puede ser encontrada adjunto del “Tenant Selection Plan”, páginas 10-11. Por favor indique aquí que usted ha recibido una copia del TSP y ha localizado las razones posibles de rechazo. _

Iniciales, Cabeza de Familia

CERTIFICACIÓN DE SOLICITANTE: Yo/Nosotros certificamos que si somos seleccionados para movernos a esta propiedad, la unidad será mí/nuestro único lugar de residencia. Yo/Nosotros entendemos que la información arriba es colectada para hacer determinaciones preliminares de mi/nuestra elegibilidad para subvención de vivienda. Yo/nosotros certificamos que las declaraciones hechas en esta aplicación son verdaderas y correctas a lo mejor de mi/nuestro conocimiento y entendimiento. Yo/nosotros comprendemos que declaraciones falsas de información son castigadas bajo la ley Federal.

Cabeza del Hogar Fecha Esposa (o)/ Co-arrendador Fecha

Otro Adulto Miembro del Hogar Fecha Otro Adulto Miembro del Hogar Fecha

Otro Adulto Miembro del Hogar Fecha Otro Adulto Miembro del Hogar Fecha

Recibida Por: Fecha: Hora:

Residencia en Napa Park Homes está abierta a todas las personas elegibles, calificadas, sin importar la raza, color, religión, origen nacional,

edad, discapacidad, sexo, estatus familiar, ascendencia, u orientación sexual.

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Form HUD- 92006 (05/09)

OMB Control # 2502-0581 Exp. (11/30/2015)

Optional and Supplemental Contact Information for HUD-Assisted Housing Applicants

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING This form is to be provided to each applicant for federally assisted housing

Instructions: Optional Contact Person or Organization: You have the right by law to include as part of your application for housing, the name, address, telephone number, and other relevant information of a family member, friend, or social, health, advocacy, or other organization. This contact information is for the purpose of identifying a person or organization that may be able to help in resolving any issues that may arise during your tenancy or to assist in providing any special care or services you may require. You may update, remove, or change the information you provide on this form at any time. You are not required to provide this contact information, but if you choose to do so, please include the relevant information on this form.

Check this box if you choose not to provide the contact information.

Applicant Name:

Mailing Address:

Telephone No: Cell Phone No:

Name of Additional Contact Person or Organization:

Address:

Telephone No: Cell Phone No:

E-Mail Address (if applicable):

Relationship to Applicant:

Reason for Contact: (Check all that apply)

Emergency Assist with Recertification Process Unable to contact you Change in lease terms Termination of rental assistance Change in house rules Eviction from unit Other: Late payment of rent

Commitment of Housing Authority or Owner: If you are approved for housing, this information will be kept as part of your tenant file. If issues arise during your tenancy or if you require any services or special care, we may contact the person or organization you listed to assist in resolving the issues or in providing any services or special care to you.

Confidentiality Statement: The information provided on this form is confidential and will not be disclosed to anyone except as permitted by the applicant or applicable law.

Legal Notification: Section 644 of the Housing and Community Development Act of 1992 (Public Law 102-550, approved October 28, 1992) requires each applicant for federally assisted housing to be offered the option of providing information regarding an additional contact person or organization. By accepting the applicant’s application, the housing provider agrees to comply with the non-discrimination and equal opportunity requirements of 24 CFR section 5.105, including the prohibitions on discrimination in admission to or participation in federally assisted housing programs on the basis of race, color, religion, national origin, sex, disability, and familial status under the Fair Housing Act, and the prohibition on age discrimination under the Age Discrimination Act of 1975.

Signature of Applicant Date

The information collection requirements contained in this form were submitted to the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The public reporting burden is estimated at 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Section 644 of the Housing and Community Development Act of 1992 (42 U.S.C. 13604) imposed on HUD the obligation to require housing providers participating in HUD’s assisted housing programs to provide any individual or family applying for occupancy in HUD-assisted housing with the option to include in the application for occupancy the name, address, telephone number, and other relevant information of a family member, friend, or person associated with a social, health, advocacy, or similar organization. The objective of providing such information is to facilitate contact by the housing provider with the person or organization identified by the tenant to assist in providing any delivery of services or special care to the tenant and assist with resolving any tenancy issues arising during the tenancy of such tenant. This supplemental application information is to be maintained by the housing provider and maintained as confidential information. Providing the information is basic to the operations of the HUD Assisted-Housing Program and is voluntary. It supports statutory requirements and program and management controls that prevent fraud, waste and mismanagement. In accordance with the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information, unless the collection displays a currently valid OMB control number.

Privacy Statement: Public Law 102-550, authorizes the Department of Housing and Urban Development (HUD) to collect all the information (except the Social Security Number (SSN)) which will be used by HUD to protect disbursement data from fraudulent actions.

social [SSN]), la cual será usada por el HUD para proteger los datos de desembolso de acciones fraudulentas.

Form. HUD- 92006 (05/09)_Spanish

El presente documento es la traducción de un documento legal emitido por el Departamento de Vivienda y Desarrollo Urbano (Housing and Urban Development, HUD). El HUD le brinda esta traducción únicamente para su comodidad, con el objeto de ayudarle a comprender sus derechos y obligaciones. La versión en inglés de este documento es el documento oficial, legal y prevaleciente. El presente documento traducido no constituye un documento oficial.

N.º de control de OMB 2502-0581

Exp. (07/31/2012)

Información de contacto opcional y complementaria para solicitantes de asistencia de vivienda del HUD

COMPLEMENTO PARA SOLICITUD DE VIVIENDA CON ASISTENCIA FEDERAL Este formulario será proporcionado a cada solicitante de vivienda con asistencia federal

Instrucciones: Persona u organización de contacto opcional: Tiene derecho por ley de incluir, como parte de su solicitud de vivienda, el nombre, la dirección, el número de teléfono y otra información relevante de un familiar, amigo u organización social, médica, de defensa o de otra índole. Esta información de contacto se recopila con el objeto de identificar a una persona u organización que puede ayudar a resolver cualquier problema que podría surgir durante su alquiler o que puede ayudar a proporcionar cualquier servicio o atención especial que usted pudiera requerir. Podrá actualizar, quitar o cambiar la información que proporcionó en este formulario en cualquier momento. No se le exigirá que brinde la información de este contacto, pero si escoge hacerlo, incluya la información relevante en este formulario.

Nombre del solicitante:

Dirección postal:

N.º de teléfono: N.º de teléfono celular:

Nombre de la persona u organización de contacto adicional:

Dirección:

N.º de teléfono: N.º de teléfono celular:

Dirección de correo electrónico (si corresponde):

Relación con el solicitante:

Motivo del contacto: (Marcar todo lo que corresponda)

Emergencia No es posible comunicarse con usted Rescisión de la asistencia de alquiler Desalojo de la unidad Pago atrasado de la renta

Ayuda con el proceso de recertificación Cambio en los términos del arrendamiento Cambio en las reglas de la casa Otro:

Compromiso del propietario o de la autoridad de la vivienda: Si es aprobado para la vivienda, esta información será conservada como parte de su archivo de locatario. Si surgen problemas durante su alquiler o si requiere de algún servicio o atención especial, es posible que nos comuniquemos con la persona u organización que incluyó para que lo ayude a resolver los problemas o le proporcione algún servicio o atención especial.

Declaración de confidencialidad: La información proporcionada en este formulario es confidencial y no será divulgada a nadie salvo según lo permitido por el solicitante o la ley vigente.

Notificación legal: La sección 644 de la Ley de Desarrollo Comunitario y de Vivienda de 1992 (Ley Pública 102-550, aprobada el 28 de octubre de 1992) exige que a cada solicitante de vivienda con asistencia federal se le ofrezca la opción de proporcionar información relacionada con una persona u organización de contacto adicional. Al aceptar la solicitud del solicitante, el proveedor de vivienda acuerda cumplir con los requisitos de igualdad de oportunidades y no discriminación de 24 CFR sección 5.105, que incluye las prohibiciones sobre discriminación en la admisión o participación en programas de viviendas con asistencia federal debido a la raza, el color de la piel, la religión, el origen nacional, el sexo, la discapacidad y el estado familiar según la Ley de Vivienda Justa, y la prohibición sobre discriminación debido a la edad según la Ley contra la Discriminación por la Edad de 1975.

Marque esta casilla si escoge no proporcionar la información de contacto.

Se eliminó el cuadro de la firma

Los requisitos de recopilación de información contenidos en este formulario fueron enviados a la Oficina de Administración y Presupuesto (Office of Management and Budget, OMB) según la Ley de Reducción del Papeleo de 1995 (Título 44, secciones 3501-3520 del Código de los EE. UU.). Se calcula que la carga de declaración pública es de 15 minutos por respuesta e incluye el tiempo para revisar las instrucciones, buscar fuentes de datos existentes, recopilar y conservar los datos necesarios, y completar y revisar la recopilación de la información. La sección 644 de la Ley de Desarrollo Comunitario y de Vivienda de 1992 (Título 42, sección 13604 del Código de los EE. UU.) impuso al HUD la obligación de solicitar a los proveedores de viviendas que participan en programas de viviendas con asistencia del HUD que proporcionen a todas las personas o familias que soliciten la ocupación de una vivienda con asistencia del HUD la opción de incluir en la solicitud el nombre, la dirección, el número de teléfono y demás información relevante de un familiar, amigo o una persona relacionada con una organización social, médica, de defensa o similar. El objeto de proporcionar tal información es facilitar el contacto por parte del proveedor de viviendas con la persona u organización identificada por el locatario para que ayude a brindar todo servicio o atención especial al locatario y ayudarlo a resolver cualquier problema de alquiler que surgiere durante el alquiler por parte de dicho locatario. Esta información de solicitud complementaria será conservada por el proveedor de vivienda y en carácter de confidencial. Proporcionar la información es básico para las operaciones del Programa de Vivienda con Asistencia del HUD y es un acto voluntario. Respalda los requisitos reglamentarios y los controles de administración y del programa para prevenir el fraude, el derroche y la mala administración. De conformidad con la Ley de Reducción del Papeleo, una agencia no podrá conducir ni patrocinar, y no se le solicitará a una persona que responda a una recopilación de información, salvo que en la recopilación de información aparezca un número de control de OMB válido en la actualidad.

Declaración de privacidad: La Ley Pública 102-550 autoriza al Departamento de Vivienda y Desarrollo Urbano de los EE. UU. (HUD) a que recopile toda la información (salvo el número de seguro

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10-15-12 Version

RESIDENT SELECTION PLAN NAPA PARK HOMES

Napa, CA Section 8 Programs

April 1, 2016 Revision

2 | NAPA PARK HOMES RESIDENT SELECTION CRITERIA-G-4-01-16

RESIDENT SELECTION CRITERIA Please read the Resident Selection Criteria carefully. These are the standards by which your application for housing will be reviewed. Management will consider the following screening criteria when determining an applicant's eligibility for residency at NAPA PARK HOMES.

A. PROPERTY ELIGIBILITY SPECIFIC REQUIREMENTS Napa Park Homes Inc. is a California based corporation which owns and operates Napa Park Homes, an apartment housing facility consisting of 140 apartments in Napa, CA. Napa Valley Community Housing acts as the managing agent for this property.

The purpose of this equal opportunity housing facility is to provide affordable housing for low, very low, and extremely low-income households through the Department of Housing and Urban Development's Sections 8 and 236 programs.

NAPA PARK HOMES has 140 apartments as follows:

116 Property Based Section 8 Apartments: 29 - 1 Bedrooms 44 - 2 Bedrooms 43 - 3 Bedrooms

24 Section 236 Apartments: 3 - 1 Bedrooms 8 - 2 Bedrooms 13- 3 Bedrooms

Residents moving into NAPA PARK HOMES must meet age and income qualifications in order to

be approved for occupancy. The United States Department of Housing and Urban Development (HUD) requires that residents be recertified annually. HUD also requires interim certification if the family income cumulatively increases by $200.00 or more per month or there is a change in household composition.

B. APPLICATION ACCEPTANCE Applications will be accepted from all persons aged 18 and above and/or emancipated minors.

Applications will be screened. When it is determined that the applicant meets the property Eligibility and Basic Program Eligibility Requirements listed in this document, the applicant will be invited to attend a personal interview.

In addition to providing income and asset documents, each household/applicant will be required to provide authorization for a credit report(s) and criminal background check(s) for all household members who are 18 years or older.

C. GENERAL INFORMATION

Residency is open to:

All qualified eligible persons in accordance with The Fair Housing Act Amendments of 1988 which prohibits discrimination in housing and housing related transactions based on race, color, religion, sex, national origin, disability and familial status.

In accordance with Title VI of the Civil Rights Act of 1964 which prohibits discrimination on the basis of race, color, or national origin in any program or activity receiving federal financial assistance from HUD.

All qualified eligible persons in accordance with any State recognized protected classes.


Section 504 of the Rehabilitation Act of 1973 prohibits discrimination based on disability in any program or activity receiving federal financial assistance from HUD.

Napa Park Homes does not discriminate based upon age for any reason, excluding HUD

program/property requirements. All interested persons, applicants, residents and the public will be given information on LEP (Limited English Proficiency) and asked if they need any assistance in applying or completing any essential documents. See LAP (Language Assistance Plan) for details.

Napa Park Homes will make "reasonable accommodations” to individuals whose disabilities in

accordance with the Napa Park Homes Reasonable Accommodation Policies and Procedures, fair housing guidelines as dictated by DFHEO and HUD regulations. This includes the application process and residency period. For more information and the designated 504 Coordinator for the site, please refer to management’s Section 504 Policy.

A person, in order to be a resident at Napa Park Homes, must be capable of fulfilling the lease

requirements. This means that the applicant must be able to meet all of his/her personal needs and be able to fulfill the lease obligations with or without assistance.

Napa Park Homes does not provide, nor has the authority to provide, any care or supervision

services, does not accept or retain residents who demonstrate any level of need for care and supervision services that cannot be provided by the resident or aides supervised by the resident, and does not promise or make available in the future any assistance with personal activities of daily living.

All potentially eligible, qualified applicants will be considered in accordance with the marketing

procedures of HUD and NAPA PARK HOMES. All applicants must comply with any applicable admissions requirements in the HUD 4350.3 Handbook.

Napa Park Homes reserves the right to alter their Resident Selection Plan at any time. In such

an event, management will provide applicants and residents with 30 days notice.

D. CITIZENSHIP REQUIREMENTS By law, only U.S. citizens and eligible non-citizens may benefit from federal rental assistance.

Compliance with these rules ensures that only eligible families receive subsidy. These requirements apply to families making application to the property, families on the waiting list and residents. Assistance in NAPA PARK HOMES is restricted to the following:

U.S. Citizens or nationals; and

Non-citizens who have eligible immigration status as determined by HUD.

All applicants who wish to be considered for the Section 8 units must submit evidence of citizenship or eligible immigration status at the time of application. All families, regardless of age must declare their citizenship or immigration status. Non-citizens (except those age 62 and older) must sign a Verification Consent Form and submit documentation of their status or sign a declaration that they do not claim to have eligible status. Non-citizens age 62 and older must sign a declaration of eligible immigration status and provide a proof of age document. Management will verify eligible immigration status though the Department of Home Land Security web site. U.S. citizens must sign a declaration of citizenship.

Mixed families, a family with one or more ineligible family member and one or more eligible family members may receive prorated assistance continued assistance, or a temporary deferral of termination of assistance.


E. INCOME REQUIREMENTS The local “Section 8” Income Limits apply to this property and applicants must meet specific

income restrictions to be eligible for housing. This facility will house extremely low, very low, and low-income elderly individuals and families, per program requirements. You may request a copy of the current income limits from the Napa Park Homes Management Office. A copy of the current income limits is referenced below.

Zero Income-An applicant or resident who claims zero income will be required to complete an

Income Questionnaire and sign a Certification of Zero Income on a quarterly basis (January, March, June and September annually). Management will check the EIV system, Department of Child Support Services and Department of Human Services for possible unreported income.

If a household reports zero income for a period of six months or more, management will require

copies of the most recent tax return and household members will be required to complete a 4506-T Form to obtain this information from the Internal Revenue Service. Maximum Income-Applicant's household income limit cannot exceed the Maximum Income

Limits for the household size as set forth by the Department of Housing and Urban Development (HUD) (See below):

Effective March 28, 2016

HUD Published Income Limits for 2016

Section 8

50% 30% Very Low Low

1 Person $30,600 $18,350 $30,600 $48,950

2 Person $35,000 $21,000 $35,000 $55,950

3 Person $39,350 $23,600 $39,350 $62,950

4 Person $43,700 $26,200 $43,700 $69,900

5 Person $47,200 $28,440 $47,200 $75,500

6 Person $50,700 $32,580 $50,700 $81,100

7 Person $54,200 $36,730 $54,200 $86,700

APPLICANTS FOR SECTION 8 SUBSIDY MUST HAVE GROSS ANNUAL INCOME AT OR BELOW THE VERY LOW INCOME LIMIT (50%) FOR NAPA COUNTY AS DEFINED BY HUD APPLICANTS FOR SECTION 236 APARTMENTS MUST HAVE ADJUSTED ANNUAL INCOMES AT OR BELOW 80% OF AMI AS PUBLISHED BY HUD. PLEASE NOTE: THESE GUIDELINES ARE UPDATED ON AN ANNUAL BASIS, NOT NECESSARILY CONCURRENT WITH THE CALENDAR YEAR.


F. SOCIAL SECURITY REQUIREMENT

*All applicant and tenant household members must disclose and provide verification of the complete and accurate SSN assigned to them except for those individuals who do not contend eligible immigration status or tenants who were age 62 or older as of January 31, 2010, and whose initial determination of eligibility was begun before January 31, 2010. This paragraph explains the requirements and responsibilities of applicants or tenants to supply owners with this information, the responsibility of owners to obtain this information, and the consequences for failure to provide the information.* Key Requirements *Applicants and tenants must disclose and provide verification of the complete and accurate SSN assigned to each household member. Failure to disclose and provide documentation and verification of SSNs will result in an applicant not being admitted or a tenant household’s tenancy being terminated. Required Documentation *Applicants and tenants must provide adequate documentation to verify the complete and accurate SSNs assigned to all household members. Adequate documentation means a social security card issued by the Social Security Administration (SSA), an original document issued by a federal or state government agency, which contains the name and SSN of the individual along with identifying information of the individual, or other acceptable evidence of the SSN listed below: . Provisions for Accepting Applicants without Documentation of Social Security Numbers *An applicant may not be admitted until SSNs for all household members have been disclosed and verification provided.

G. VALIDATION OF SOCIAL SECURITY NUMBER NAPA PARK HOMES will confirm HUD’s validation of the tenant’s SSN by viewing the Household’s Summary Report and the Identity Verification Report in the EIV system.

H. TIMEFRAME FOR PROVIDING SOCIAL SECURITY NUMBERS APPLICANTS CURRENTLY ON OR APPLYING TO WAITING LIST

Applicants do not need to disclose or provide verification of a SSN for all non-exempt household members at the time of application and for placement on the waiting list. However, applicants must disclose and provide verification of a SSN for all non-exempt household members before they can be housed.

I. HOUSING APPLICANTS FROM THE WAITING LIST If all household members have not disclosed and/or provided verification of their SSNs at the

time a unit becomes available, the next eligible applicant must be offered the available unit.

The applicant who has not disclosed and provided verification of SSNs for all household members must disclose and provide verification of SSNs for all household members to the owner within 90 days from the date they are first offered an available unit.*

If the owner has determined that the applicant is otherwise eligible for admission into the property, and the only outstanding verification is that of *disclosing and providing verification of* the SSN, the applicant may retain his or her place on the waiting list for the *90*-day period during which the applicant is trying to obtain documentation.

After *90* days, if the applicant has been unable to supply the required SSN *and verification* documentation, the applicant should be determined ineligible and removed from the waiting list.


J. VERIFICATION OF SOCIAL SECURITY NUMBER Napa Park Homes will verify and document each disclosed SSN by:

Obtaining the documentation listed below from each member of the applicant’s or tenant’s household:

Acceptable Verification Documents Social Security Card If you do not have a Social Security Card, Napa Park Homes may ask you to provide one or more of the following documents:

1. Original document issued by a federal or state government agency which contains the name, SSN, and other identifying information of the individual* 2. Bank Statement 3. Benefit Award Letter 4. Court Records 5. Driver’s license with SSN 6. Earnings statements on payroll stubs 7. Identification Card Issued by a Medical Insurance Provider, or by an

Employer or Trade Union. 8. Form 1099 9. Life Insurance Policy 10. Retirement Benefit Letter

Making a copy of the original documentation submitted, returning the original to the individual

and retaining the copy in the file folder;

Recording the SSN on line 45 of the form HUD-50059 and transmitting the data to TRACS in a timely manner.

To ensure that the SSN transmitted to TRACS is valid, Napa Park Homes will use the

Failed EIV Pre-Screening Report and the Failed Verification Report in EIV in accordance with the instructions in the current HUD Housing Notice, Enterprise Income Verification System.

The Failed EIV Pre-Screening Report identifies residents who failed the EIV pre-screening

test due to invalid or missing personal identifiers. The Failed Verification Report identifies residents that have had their personal identifiers sent to SSA, via HUD’s computer matching program with the SSA, but the data could not be verified by SSA due to missing or invalid information or other SSA issues.

SOCIAL SECURITY NUMBER DOCUMENT REJECTION We will reject a document that:

Is not an original document; or Is the original document but it has been altered, mutilated, or is not legible; or Appears to be a forged document (e.g., does not appear to be authentic).

Applicant or tenant will be notified in writing regarding the reason(s) why the document(s) is not acceptable and request the individual obtain acceptable documentation.


ONCE SOCIAL SECURITY NUMBER VERIFIED Once the individual’s SSN has been verified, Napa Park Homes will remove and destroy

the copy of the documentation referenced above by no later than the next recertification of family income or composition.

Paper documentation may be destroyed by shredding, pulverizing or burning. Currently,

Napa Park Homes uses the shredding method.

Electronic documentation will be destroyed by erasing or permanently deleting the file.

The retention in the tenant file of the Household Summary Report from the EIV system which will report the status of the identity verification process provides verification of the SSN. Retaining this report in the tenant file and destroying the copy of the SSN documentation will minimize the risk of exposing the individual’s SSN.

K. ELIGIBILITY REQUIREMENT FOR STUDENTS WHO ARE HEAD OR CO-HEAD OF A HOUSEHOLD The applicant who is the head and/or co-head in the household must be of legal contract age under state law. The individual must have established a household separate from parents or legal guardians for at least one year prior to application for occupancy or he/she meets the U. S. Department of Education’s definition of an independent student. The individual must not be claimed as a dependent by parents or legal guardians pursuant to IRS regulations. The individual must obtain a certification of the amount of financial assistance that will be provided by parents, guardians or others signed by the individual providing the support. This certification is required even if no assistance will be provided. The financial assistance provided by persons not living in the unit is part of annual income that must be verified to determine eligibility and at annual recertification to determine rent.

L. POLICY FOR ELIGIBILITY OF STUDENTS TO RECEIVE SECTION 8 ASSISTANCE Restrictions on Eligibility of Students for Section 8 Assistance NAPA PARK HOMES is required to determine whether applicants are eligible to occupy the

subsidized property and receive housing assistance. Eligibility is determined by federal statute and HUD regulation. For HUD programs, eligibility is only determined at move-in or at initial certification except as discussed in paragraphs **3-13, Determining Eligibility of College Students for Assistance** and paragraphs **3-16 of the HUD 4350.3 Handbook, Determining the Eligibility of a Remaining Member of a Resident Family. **HUD's general eligibility requirements are found in HUD's regulations at 24 CFR, part 5.

No assistance shall be provided under Section 8 of the 1937 Act to any individual whom:

a) Is enrolled as either a part-time or full-time student at an institution of higher education for the purpose of obtaining a degree, certificate, or other program leading to a recognized educational credential;

b) Is under the age of 24; c) Is not married; d) Is not a veteran of the United States Military; e) Does not have a dependent child; f) Is not a person with disabilities, as such term is defined in (b) (3) (E)) and was not

receiving section 8 assistance as of November 30, 2005 g) Is not living with his or her parents who are receiving Section 8 assistance; and h) Is not individually eligible to receive Section 8 assistance and has parents (the

parents individually or jointly) who are not income eligible to receive Section 8 assistance

For a student to be eligible independent of his or her parents (where the income of the parents is not relevant), the student must demonstrate the absence of, or his or her independence from, parents. NAPA PARK HOMES may use additional criteria for determining the student’s independence from parents and the student must meet, at a minimum all of the following criteria to be eligible for Section 8 assistance. The student must:


a) Be of legal contract age under state law; b) Have established a household separate from parents or legal guardians for at

least one year prior to application for occupancy, or Meet the U.S. Department of Education’s definition of an independent student.

c) Not be claimed as a dependent by parents or legal guardians pursuant to IRS regulations; and

d) Obtain a certification of the amount of financial assistance that will be provided by parents, signed by the individual providing the support. This certification is required even if no assistance will be provided.

Any financial assistance a student receives (1) under the Higher Education Act of 1965, (2) from private sources, or (3) from an institution of higher education that is in excess of amounts received for tuition is included in annual income, except if the student is over the age of 23 with dependent children or if the student is living with his or her parents who are receiving Section 8 assistance. If an ineligible student is a member of an applicant household or an existing household receiving Section 8 assistance, the assistance for the household will not be prorated but will be terminated in accordance with the HUD guidance

During the application process, management will appropriately screen applicants and households for eligibility under this final rule. An applicant who is a student and who does not meet the income eligibility requirements or jointly, do not meet the income eligibility requirements for Section 8 assistance are not eligible for Section 8 assistance and will be prohibited from participating in the program. A student under the age of 24 who is not a veteran, unmarried, does not have a dependent child and who is currently receiving Section 8 assistance, if at recertification is determined to be ineligible, will have his/her assistance terminated.

NAPA PARK HOMES will determine a student’s eligibility for Section 8 assistance at move-in, annual recertification, initial certification (when an in-place resident begins receiving Section 8), and at the time of an interim recertification if one of the family composition changes reported is that a household member is enrolled as a student

**Students with disabilities receiving Section 8 as of November 30, 2005 are exempt from the Independent Student restrictions on receiving Section 8 Rental Assistance.

NOTE: NAPA PARK HOMES cannot evict or require an ineligible student to move from a unit as long as the student is in compliance with the terms of the lease.

M. RESIDENCE CRITERIA A. KEY REQUIREMENT

Assisted tenants must have only one residence and receive assistance only in that unit. This rule is meant to ensure that the government pays assistance on Only one unit for a family and provides assistance to as many eligible families as possible with available funding. B. SOLE RESIDENCE REQUIREMENT 1. A family is eligible for assistance only if the unit will be the family’s only Residence. 2. The owner must not provide assistance to applicants who will maintain a Residence in addition to the HUD-assisted unit. C. PROHIBITION AGAINST DOUBLE SUBSIDIES Under no circumstances may any tenant benefit from more than one of the following subsidies: RENT SUPPLEMENT, RAP, SECTION 202 PAC, SECTION 202 PRAC OR SECTION 811 PRAC, OR PROJECT-BASED SECTION 8 HOUSING ASSISTANCE, INCLUDING SECTION 202/8.


1. Tenants must not receive assistance for two units at the same time.

2. Tenants must not benefit from housing choice voucher assistance in a Unit already assisted through PROJECT-BASED SECTION 8, RENT SUPPLEMENT, RAP, SECTION 202 PAC OR SECTION 202 **PRAC** AND **SECTION** 811 PRAC. This prohibition does not prevent a person who is currently receiving Assistance from applying for an assisted unit in another property. The Assisted tenancy in the unit being vacated must end the day before the Subsidy begins in the new unit.

N. PROCEDURES FOR ACCEPTING APPLICATIONS AND SELECTING FROM THE WAITING LIST All persons/families interested in applying for housing at Napa Park Homes must comply with

the following requirements to be "considered for housing": Applications may be picked up at the Management Office located at 790 Lincoln Avenue,

Napa, California, 94558 between the hours of 9:00 a.m. - 12:00 p.m. and 1:00 p.m.- 5:00 p.m., Wednesday and Thursday.

Requests for an application to be sent through the mail may be made by writing to the above

address or by telephoning (707) 255-3119 during the above business hours. Applications should be returned during business hours in person or via first class mail. Allowances will be made for persons with mobility impairments, who request a reasonable accommodation or who live out-of-state. Applications will be date and time stamped and applications will enter the Waiting List in the chronological order of receipt.

Application must list all family members who will reside in the unit.

Applicant must present an acceptable credit/criminal history per credit and criminal

screening criteria established by management, as reported by a credit bureau and/or by any credit references listed on the application. A credit/criminal report will be run on the applicant(s) by the Napa Park Homes in accordance with HUD Notice H2012-11, all applicants age 18 or older will be subject to a criminal background check. Applicant must not have an eviction for drug related criminal activity or display a pattern of abuse of alcohol that would interfere with the health, safety or right to a peaceful enjoyment of the premises by other residents. No family member can have a conviction other than acquittal for any sexual offense.

Provide good/acceptable references from all landlords, both current and previous, listed on the application and in credit bureau files.

Provide proof of citizenship for household members as well as social security numbers for members of the family in accordance with Sections E, F, G and H of this document.

Show that the applicant has the ability to fulfill all the lease requirements (with or

without care assistance) where applicable.

Demonstrate satisfactory housekeeping habits that will not jeopardize the health, security or welfare of other residents.

All of this information will be verified in accordance with HUD Regulations and Requirements, as stated in HUD Handbook 4350.3 and all revisions. Applicants will be required to sign appropriate forms authorizing management to verify any and all factors that affect the applicant’s eligibility or the rent that the applicant will pay. All of this information may be released by HUD to other Federal, State and Local Agencies.

In the event the applicant is personally unable to complete the form, the applicant must

provide the information to someone assisting in completing the form. The person assisting the applicant must sign and date the application, indicating that it was completed at the direction of the named applicant.


If an applicant fails to supply all necessary verification forms, information, or meet the requests of the application process, or Napa Park Homes cannot obtain verification of specific required information due to illegible forms/application, the applicant will be rejected (please refer to Rejection Procedures for further information).

**If the applicant is a person with disabilities, Management must consider extenuating circumstances where this would be required as a matter of reasonable accommodation.

O. PROCEDURE FOR ACCEPTING APPLICATIONS AND PRE APPLICATIONS 1) Initial Application. Applications are taken only when the Wait List is open for unit

type being requested. This property does not use pre applications. All Prospective residents 18 years and over must fill out the application in full. The form is reviewed with the applicant(s) if application is returned in person to make sure that answers are clear and that all information is given. All persons intended to reside in the apartment must be named, and no one not listed may live in the unit. If an appropriate unit is available now or in the near future, and no eligible waiting list applicant has priority, the application is processed immediately for approval or rejection.

The application information allows tentative determination (subject to confirmation) of the applicant’s eligibility (family size, household characteristics, estimated anticipated annual income, assets now owned and disposition of assets during the previous two years.) Disability status is required only if the applicant is requesting a disabled-accessible unit or special accommodation. Applications may be picked up and dropped off in the management office between the hours of 9:00 a.m. - 12:00 p.m. and 1:00 p.m. - 5:00 p.m. on Wednesday and Thursday. We do not accept faxed copies. You may also mail your completed application. See above for address.

2) Pre-Qualifying Eligibility. The three applicants at the top of the waiting list are considered

active prospects even if a unit is not yet available. Steps are taken to qualify the applicants so that when a unit becomes available the pre-screening, including verifications, is already completed. Verifications are kept current within 120-day periods. If the top applicant is found to be ineligible, the next party on the wait list is the lead applicant.

3) Interview. An interview is held to determine final qualifications of the applicant to be placed in the next available unit. Application information is updated, the applicant is advised of the penalty for false information, current income and asset data are checked, and additional verification forms are signed if needed. Social Security information or certifications are given. Potential accommodation for disabled applicants is considered. Final occupancy determination is not made until certification procedures are completed.

Upon receipt of the original application, the application is preliminarily reviewed. The

initial review will be for application completeness, to make sure that the application is legible and to initially determine if the applicant appears to qualify for the Section 8 Program. This in no way means that an applicant qualifies, or is eligible. Eligibility can be confirmed only after all items, which may have any bearing on the rent that the applicant may pay, or subsidy he/she may receive are verified: income, assets, family composition, etc. The applicant must be determined eligible to be offered housing.

As an applicant's name approaches the top of the Waiting List, or when an applicant is

being offered housing, a formal interview will be scheduled. At that time the applicant is interviewed, all items on the application will be discussed and confirmed, and verification forms will be signed by the applicant authorizing management to verify all of these issues/items. Until all items are verified, eligibility cannot be determined, nor any housing offered. Management must attempt to verify all factors with "third party" written verification, per HUD Regulations and Procedures.


In the absence of third party verification within 14 days after attempting third party verification, and no response being received, management will use “Review of Documents” to verify items/issues in accordance with the HUD Handbook 4350.3 and all revisions.

4) Placement on Wait List. A wait list is maintained for each unit type. If no appropriate-

type unit is available for eligible applicants, they are placed on the list for desired unit type, if requested. Based on current experience with turnover on that unit type, an estimate is made as to the possible length of waiting time. No promise is made, since conditions, time schedules and priorities may change.

Any applicant who appears to qualify after Napa Park Homes reviews the application,

but before any information is formally verified, and for whom a unit is not currently available, will be placed on the Waiting List. All received applications are noted with date and times received, and enter the Waiting List in the chronological order of receipt. One Waiting List is maintained for all apartments at Napa Park Homes. The applicant is informed of the approximate wait for a unit and/or placement position on the waiting list. It is the applicant’s responsibility to report changes on the application to Napa Park Homes in a timely fashion.

Any applicant on the Waiting List is required to contact Napa Park Homes every six (6)

months to update their information, by completing a revised application form when necessary. Any applicant on the Waiting List is required to contact the Napa Park Homes when a change of address, phone, income or family composition occurs. This contact must be done in the form of writing. Contact may be initiated by Napa Park Homes in the form of a routine letter/postcard, sent to all applicants on the Waiting List, requesting update information, asking if they wish to remain on the Waiting List and stating that if the letter is not responded to within fourteen (14) days, their name will be dropped from the Waiting List without further notice.

When the number of names/families on the Waiting List for any particular size exceeds

the annual apartment turn over for that size unit, the Waiting List may be closed. Management will advise potential applicants of the closure of the waiting list and refusal to take additional applications. A notice will be prominently posted in the Management/rental office or reception area and in a local newspaper, stating the reason Waiting List is closed and the effective date of the closure. When the Waiting list is to be reopened, notice of this will be placed in the same local publication, as well as notifications sent to appropriate social service agencies stating when the Waiting List will be re-opened, as well as times and days that applications will be taken. This is done in accordance with the Affirmative Fair Housing and Marketing Plan (HUD Form 935.2A).

If an applicant on the Waiting List is offered an apartment and refuses the offered

apartment, he or she may remain on the Waiting List if the refusal is for a verifiable medical reason. The applicant will move to the bottom of the Waiting List. Any other refusal reasons are considered valid reasons for refusal at management's discretion. In any event, a second refusal, for any reason other than one due to a disability, will cause the application to be rejected and the applicant's name removed from the Waiting List. This applicant may reapply in the future, at a time that applications are being taken.

When a unit becomes available, in-place residents requiring a different unit will be

housed appropriately before we move in an applicant on the Waiting List. This allows management to treat current residents having the greatest housing need prior to applicants on the Waiting List. In this manner, we are able to avoid displacing, through any action, current residents whose housing needs have changed since admission.

Applicants who are experiencing hardships due to health or financial reasons will not be

moved from their original date on the waiting list if proper documentation is received by management.

5) Notification and Updating. The applicant is notified when an appropriate unit is available.

Applicant interest is verified at least annually. The applicant can be asked to re-contact the office


in six months; however, management is responsible for reviewing the list and confirming continued applicant interest and eligibility. An annual inquiry letter sent by management does this. If there is no response from applicant within two weeks after sending letter, or a negative response (returned undeliverable), the applicant is removed from the waiting list.

6) Applicant Refusal. Applicants who are offered occupancy and refuse an apartment two different times will be removed from the waiting list, unless the applicant has a verified “hardship”. A “hardship” will be defined as, but not limited to, undue financial burden or poor health.

7) Holding Period. An apartment will be held for a maximum of 14 days for an applicant (from the time the applicant is notified that an apartment is available) to effective date of the lease.

8) Changes to Application. All changes to the application and waiting list updates must be in writing from the applicant. Changes to the application will become effective when received from the applicant at the rental office. It is the responsibility of applicant to notify management of any changes to the contact information. Applicants may be rejected if they do not keep management informed of current contact information.

9) Process Start. When the applicant’s name nears the top of the Waiting List, the detailed verifications process begins. Resident files contain documentation of all verifiable data. All information pertinent to the eligibility, admission and continued occupancy of a resident household must be verified in accordance with Federal program regulations. Interviewing and documentation will be completed by the management staff to ensure that all applicants/residents are made aware of the Federal program regulations. Verifications will be used to determine if all of the information contained on the Application/Recertification Checklist is true and correct. Information to be verified includes, but is not limited to:

Allowances Assets Credit History Criminal Record Enterprise Income Verification (EIV) will be used to determine if applicants are receiving

Section 8 subsidy from their current landlord Enterprise Income Verification (EIV) will then be used on all residents at their interim and

annual recertifications to check the records kept by certain public agencies Family Composition Income from all sources Rental History SAVE System for noncitizen status

Interview. The eligible applicant/resident is interviewed by the Management Representative to determine their eligibility status. At this time the applicant/resident is requested to sign releases for verification. Documents. All “permanent” documents (photo identification i.e. driver licenses, birth certificates, social security cards, etc.) are photocopied and placed in the applicant/resident file, at the time of application. Independent Verification. Third parties are used as a primary source for information. Release Consent. All applicants and residents (age of 18 and up) are required to sign Consent to the Release of information (HUD 9887 AND 9887a) at admission, annual recertification, interim recertification or initial certification. Failure to do so is grounds for rejection or termination of your lease. Zero Income. An applicant or resident who claims zero income will be required to complete and sign a Certification of No Income on a monthly basis by the sixth (6th) of each month. If an applicant/resident does not apply for benefits for which they may be qualified (e.g., AFDC, unemployment, child support, etc.), verification by the Management Representative of not receiving benefits is not required. However, there must be a signed statement from the applicant/resident verifying that they have chosen not to participate in the benefit program for which they may be eligible in the applicant file.


P. ENTERPRISE VERIFICATION SYSTEM (EIV)

The use of the EIV system as upfront income verification (UIV) technique, serves as a valuable tool in validating tenant reported income during interim and annual recertifications of family income; as well as in streamlining the income verification process, resulting in less administrative burden in complying with third party verification requirements. EIV helps identify and cure inaccuracies in housing subsidy determinations, which benefits Napa Park Homes, residents and taxpayers by ensuring that the level of benefits provided on behalf of families is proper. Finally, the use of EIV assists in preventing fraud, waste and abuse within Multifamily Housing’s Rental Assistance Programs. EXISTING TENANT SEARCH REPORT This report identifies applicants applying for assisted housing that may be receiving rental assistance at the time of application processing at another location. We will use this report during the interview process as follows:

(1) When we are processing an applicant for admission to determine if the applicant or any applicant household members are currently being assisted at another Multifamily Housing or Public and Indian Housing (PIH) location. (2) Discuss with the applicant if the report identifies that the applicant or a member of the applicant’s household is residing at another location, giving the applicant the opportunity to explain any circumstances relative to his/her being assisted at another location. (3) Follow up with the respective PHA or O/A to confirm the individual’s program participation status before admission, if necessary, depending on the outcome of the discussion with the applicant. The report gives Napa Park Homes the ability to coordinate move-out and move-in dates with the PHA or Owner/Agent of the property at the other location. (4) Retain the search results with the application along with any documentation obtained as a result of contacts

ANNUAL RECERTIFICATION A current form HUD-9887 must be on file before accessing the employment or income data contained in EIV for a tenant. The form must be signed and dated by:

(1) Each adult member of a household regardless of whether he or she has income.

(2) The head of household, spouse or co-head, regardless of age, and each family member who is 18 years of age or older must sign and date the form at move-in, at initial (when tenant begins receiving a subsidized rent, e.g., Section 236, tenant begins receiving Section 8 and annual recertification) (3) A family member when he/she turns 18.

The form is valid for 15 months from the date of signature.

Q. PROCEDURES FOR APPLYING PREFERENCES INCLUDING INCOME-TARGETING IN SECTION 8 PROPERTIES

1) Preferences. Napa Park Homes has permanently suspended Federal Preferences, in accordance with HUD

directives. However, preference will be given to individuals and families displaced by government action or a presidentially declared disaster. In the event of such a displacement by government action, selection of displaced applicants will follow in compliance with the Extremely Low Income requirements.


Preferences affect only the order of applicants on the Wait List. They do not make anyone eligible who was not otherwise eligible, and they do not change management’s right to adopt and enforce resident screening criteria (please refer to ELI Procedures within this Plan for further information).

2) Special Priority. NAPA PARK HOMES has no apartments especially equipped for persons with physical disabilities. Reasonable accommodations will be made for those people who are disabled in accordance with Section 504.

3) Income-Targeting (HUD 4350.3: 4-5). NAPA PARK HOMES is required to lease not less than 40% of the dwelling units (assisted under the contract) that become available for occupancy in any property fiscal year to extremely low-income families. To accomplish this income-targeting requirement, management will alternate between the first extremely low-income applicant on the waiting list and the applicant at the top of the waiting list (HUD 4350.1, 4-5 B 2 b (2)). To implement this method, NAPA PARK HOMES will select the first extremely low-income applicant on the waiting list (which may mean “skipping over” some applicants with higher incomes) for the available unit, and then select the next eligible applicant currently at the top of the waiting list (regardless of income level) for the next available unit. As subsequent units become available, resident selection continues to alternate between the next extremely low-income applicant and the eligible applicant and the eligible applicant at the top of the waiting list until the 40% target is reached. A status letter will be sent to any qualified applicant who may have been skipped over in order to meet HUD required income targeting.

R. APPLICANT SCREENING CRITERIA

The following are areas management will consider when approving applicants for residency: Assets In accordance with the Department of Housing and Urban Development’s guidelines, we will apply an asset test to all applicants. Assets include all liquid asset accounts, including but not limited to Checking Accounts, Certificates of Deposit, Gifts, Savings Accounts and stocks. Causes for Rejection An applicant will only be rejected after consideration of the Mitigating Circumstances Policy, including but not limited to successful rent payment history over the past 36 months. The causes for rejection are further outlined in each of the sections noted below. Certification Process Upon initial occupancy, household income cannot exceed the income restriction for the respective unit size as determined by the area median income which is adjusted for household size. Third-party income verification will be required from all sources, including, but not limited to:

Child/Spousal/Family support; Disability; Employment; Government Assistance, SSI, TANIF, AFDC, GA, etc.; Pensions/Retirement/Annuities; Property, Home, Stocks, Bonds, Annuities, IRA, etc.; Savings and Checking; Social Security; Unemployment Benefits

Income calculations are based on the household’s annual anticipated gross income for the 12 (twelve) months. Annual gross income includes income from any and all assets.


Credit A credit check will be run on all applicants 18 years and over at initial certification as condition of occupancy. Credit standards are set forth below:

Applicant passes review by credit agency and/or by direct contact with banks and other financial sources. Lack of credit history in itself does not justify rejection. Past credit problems may be explained by the applicant so that credit judgment is made on current information.

Credit reports are pulled for all adult household members. Each member must meet the same requirements. Although there are some exceptions listed below in the Reasons to Overturn a Rejection upon Appeal Section, reasons for rejection of an application due to information contained on applicant’s credit report include the following factors that have affected applicant’s ability to pay rent in prior tenancies: Bankruptcy/Repossessions

Any personal bankruptcy within the past thirty six months that has not been remedied

Charge-Offs/Collections

Accounts over 120 Days Past Due within the past thirty six months “Charge-Off” of delinquent debt within the past thirty six months Unpaid collections, judgments or liens exceeding $5,000.00, excluding

medical bills and student loans within the past thirty six months; Unpaid balance due a current or prior landlord; A significant number (3) of Non Sufficient Funds (NSF) checks within

the past thirty six month period; Evictions/Prior Landlords/ Unlawful Detainers

A negative Unlawful Detainer Report indicating repeated failure to meet financial obligations in past tenant history within the last thirty six months

An eviction for cause within the past thirty six months for any reason other than documented medical hardship

Foreclosures, Mortgage Defaults, Reverse Mortgage and Short Sales Applicants who have a foreclosure, mortgage defaults, reverse mortgage or short sale will be denied, however, management will allow applicant 14 days in accordance with the Napa Park Homes Grievance and Appeal Procedure for the applicant to provide additional information regarding the default or foreclosure. The information will be evaluated on a case-by-case basis. Lawsuits

Any suit pending or not remedied which is deemed to affect financial ability

Examples of the type of lawsuits which would fall into this category include:

Bankruptcy That Has Not Been Discharged Check Fraud Embezzlement Eviction Welfare Fraud

Repossessions

Repossessions, excluding voluntary repossessions within the past thirty-six months except when part of a bankruptcy, divorce or legal separation


Tax Liens

Current tax liens

Reasons to overturn a rejection upon appeal include: Applicant lacks credit history, since lack of a credit history does not

constitute negative credit. Applicant can prove that a prior eviction or poor credit is the result of a

divorce or the result of the applicant having been a victim of domestic violence and that it was determined in a court settlement that the applicant’s spouse was solely responsible for such poor credit or eviction and such spouse will not be living with applicant at NAPA PARK HOMES; or,

Applicant can prove that a prior eviction or poor credit is the result of a documented medical hardship

Proof of adherence to a payment plan for past due collections; or, The unlawful detainer was caused by non-payment of rent and that

any future rent payment is guaranteed by third party payment. Criminal Activity A criminal background check will be run on all applicants 18 years and over at initial certification and each annual recertification as condition of continued occupancy.

A criminal background check will be required for all household members aged eighteen [18] years and older and emancipated minors. Criminal standards are set forth below. Facts regarding behavior of one or more members of the household and prior conduct requiring police and/or court action will be considered. A criminal background reference check is conducted to determine if applicants and/or members of an applicant’s household have any criminal background. During the admissions screening process, NAPA PARK HOMES must perform the necessary criminal history background checks in the state where the housing is located and in other states where the household members are known to have resided; Applicant households will be reviewed to determine that they have not had any of the following: NAPA PARK HOMES is required to deny admission to Federally-assisted housing if:

Any household member has been evicted from Federally-assisted housing for drug-related criminal activity, for three years from the date of eviction. If the evicted household member who engaged in drug-related criminal activity has successfully completed a supervised drug rehabilitation program or circumstances leading to the eviction no longer exist, NAPA PARK HOMES may, but is not required to, admit the household.

Any household member is currently engaging in illegal drug use. NAPA PARK HOMES determines that there is reasonable cause to believe that a household

member’s illegal use or a pattern of illegal use of a drug may interfere with the health, safety, or right to peaceful enjoyment of the premises by other residents. (Examples of evidence of illegal activities may include a conviction record, former landlord references, etc.)

Any member of the household is subject to a lifetime registration requirement under a

National Sex Offender registration program. In accordance with Federal law, NAPA PARK HOMES shall establish standards that prohibit admission to any federally assisted property to sex offenders subject to a lifetime registration requirement under a state sex offender registration program. During the admissions screening process, NAPA PARK HOMES must perform the necessary criminal history background checks in the state where the housing is located and in other states where the household members are known to have resided.


NAPA PARK HOMES determines that there is reasonable cause to believe that a household

member’s abuse or pattern of abuse of alcohol interferes with the health, safety, or right to peaceful enjoyment of the premises by other residents.

Employment If applicant is scheduled to begin employment, but has not yet received his or her first paycheck, applicant must provide an Offer Letter from employer submitted on employer’s letterhead. This letter must include the following information:

Hire Date Rate of Pay Number of Hours Worked Per Week Number of Overtime Hours Per Week Number of Shift Differential Hours Per week Bonuses Scheduled Commissions Anticipated Raises Within Next 12 Months Tips

Falsification of Application All information provided on the application will be verified. False, inaccurate or incomplete information may result in disqualification of an application. Intentionally providing false information on any part of the application is considered fraud and may result in failure of the applicant to obtain a unit, or if discovered after an applicant becomes a resident, may result in loss of the assigned housing unit. All income will be verified by management via third party verification from employers and/or other sources of income. HUD Occupancy Criteria Meets all HUD occupancy criteria. Income is not more than 50% of median income in the area (“Very Low Income”), for the 126 Section 8 apartments. Income and rent computations, documentation requirements and verification procedures are explained in HUD 4350.3 Chapter 3. Identification In order for household background check to be performed, all household members age 18 and above must provide one form of identification from the list below:

Birth Certificates- for household members under age 6 Driver’s License Government Issued Photo Identification Card Passport State Identification Card Visa

Income Documentation We will consider Gift/Family Support from a family member as “other” income if the family member can show proof of 12 times the amount of monthly subsidy in a bank account and complete our “Gift/Family Support Affidavit Form” (which must be notarized) for those households with incomes that fall below our minimum income requirements. The following criteria will be considered in conjunction with the Mitigating Circumstances Policy.

References from applicant’s current and previous landlords for a period of three

years will be reviewed.

All applicants must have positive prior landlord references indicating ability to care for the property and pay rent on time, as well as the ability to peacefully cohabitate with other residents. A history of violent or criminal behavior may be cause for denial of application.


Keeps Agreements Demonstrated ability and willingness to keep lease agreements, including: pay rent on time, maintain the unit in good condition, respond to recertification requirements, cooperative occupancy habits (noise, trash, etc), no family member uses illegal drugs. This information is obtained from prior landlords, personal credit and criminal references.

Landlord Reference Check A landlord reference check of an applicant’s rental history for the past thirty six (36) months is conducted to determine the following:

Demonstrated ability to pay rent on time and in full; Demonstrated ability to live peacefully with others; Followed the rules and regulations of rental companies; Kept rental unit in a manner which did not create an unsafe or unhealthy

environment or pose a health danger to other residents; Kept rental unit undamaged; No history of receiving notices for lease violations; Gave sufficient notice of intent to vacate; No noise complaints; No disturbances or illegal activities; No unpaid Non-Sufficient Funds (NSF) checks; No unauthorized household members No blatant disrespectful, disruptive or antisocial behavior toward the

management or staff, the property, or other applicants/residents No sales of narcotics No eviction for cause with exception off documented medical hardship No destruction or theft of property No acts that threaten the health, safety or welfare of other residents

Applicants who have past evictions or negative landlord references strictly for non-payment of rent, but who now have a verified payee to guarantee timely rent payment, will not be automatically declined under the eviction or rental history criterion described above. However, subject to reasonable accommodations, applicants will be declined for evictions for other causes. In cases where applicants do not have any previous landlord, or if no previous landlord is available, staff will request personal references from someone not related to the applicant, such as a counselor or caseworker. However, lack of such references is not an automatic basis for denial. Other Allowable Screening Criteria EIV as noted in Section N above. References Have favorable (or no unfavorable) comments from prior landlords, personal and credit references. Mitigating circumstances will be considered. Retired or Unemployed Individuals Retired or Unemployed Individuals must supply the previous year’s signed tax returns. Security Deposit Household must be able to pay a deposit as calculated on 50059 Form. Installment agreements are available. Seasonal Employment Individuals who receive income from seasonal employment will need to provide the previous years signed tax returns.


Self-Employed Individuals Self- employed individuals must be able to provide last two years of signed tax returns; past, present and projected Profit and Loss Statements. Self-employed individuals must also sign a Self-Employment Affidavit which must be notarized.

S. PROCEDURES FOR REJECTING INELIGIBLE APPLICANTS

The following are reasons why applicants will be rejected.

1) HUD Criteria. The applicant does not meet HUD’s occupancy requirements, including unit size, unit type, income limits, etc.

2) Lack Of Adequate Information. The applicant refuses to or cannot provide all required

application information including Social Security numbers or certifications. Refusing to sign required documents (i.e. Verification Authorization forms, Consent to Release of information, etc.) will be grounds for rejection.

3) Negative References. The prior landlord(s) up to three years back or other references

provide negative reports regarding keeping of lease terms, payment of rent and other occupancy obligations, housekeeping habits, engaging in illegal activity, or incompatibility with other residents and neighbors. These reports are verified as much as possible and the applicant is given a fair opportunity to overcome negative reports by explaining mitigating circumstances. These explanations must be verified. Mitigating circumstances can include disabled-related problems when there is the potential to overcome those problems through reasonable accommodation.

4) Credit. All available credit references are checked without charge to the applicant.

Rejection is possible if credit reports contain substantive negative information. (If other criteria are satisfactory, the applicant is given an opportunity to respond to negative credit reports.) Examples of poor credit are:

a) left prior housing owing money to landlord; b) prior eviction unless for documented medical emergency; c) An account in collection status exceeding $5,000.00; d) bankruptcy within the last three years (36 months) for reasons other than

medical emergency, divorce, death of spouse; e) civil judgments against the applicant not yet resolved.

Circumstances will be reviewed and applicant responses considered. Applicants who have been previously evicted or are currently under eviction will be rejected.

5) Criminal Record. Facts regarding behavior of one or more members of the household

and prior conduct requiring police and/or court action will be considered. The basis for rejection includes but is not limited to the following:

a) Any conviction or adjudication other than acquittal for generally violent crimes and felonies in all states, including but not limited to: criminal homicide, manslaughter, robbery, assault, arson, etc.

b) Any conviction or adjudication other than acquittal that involved injury or potential injury to a person or property.

c) Any conviction or adjudication other than acquittal for generally non-violent crimes, the severity or existence of crime vary from state to state including, but not limited to other simple assaults, forgery, fraud, embezzlement, weapons, etc.

d) Any conviction or adjudication other than acquittal for the sale, distribution or manufacture of any controlled or illegal substance.

e) Any conviction or adjudication other than acquittal involving illegal use or possession of any controlled or illegal substance.

f) Any current illegal user or addict of a controlled or illegal substance.


g) Any act which results in the person’s tenancy constituting a threat to the health or safety of other individuals, result in substantial physical damage to the property of others, or interfere with the peaceful and quiet enjoyment of the premises.

h) Any conviction or adjudication other than acquittal, for any sexual offense. i) Registration on any state sex offender registry. j) Any conviction or adjudication other than acquittal, which involved bodily harm

to a child. k) Any conviction or adjudication other than acquittal, for domestic violence, dating

violence, sexual assault or stalking. l) Eviction for Drug Related Criminal Activity from federally assisted housing for

drug related criminal activity within the last 3 years. m) Alcohol abuse or pattern of abuse, of alcohol interferes with the health, safety or

right to peaceful enjoyment of the premises by other residents.

Applicants have an opportunity to explain all adverse references. Individuals with such records will not be admitted even if other eligible family members are admitted. Any applicant or household member who has been arrested for any of the above-described offenses will have their application suspended until the case has been legally resolved.

(6) Notification. If management rejects an applicant for any reason a rejection letter will be

sent to the applicant. This letter will state in writing the reasons and provide an opportunity for the applicant to respond or ask for a meeting. If applicant wishes to appeal the rejection they must do so within 14 days. If requested by applicant the meeting will be with a staff member or agent who is not the same person who made the original rejection determination. A follow-up written response will be sent within five days of the rejection hearing. Rejection records will be kept at least three years.

NOTE: Applicants with no verifiable rental or credit history will be given due consideration using personal references from three reliable sources other than relatives or close friends (e.g. clergyman, teachers, employers, etc.)

T. OCCUPANCY STANDARDS The occupancy limits are as follows:

Apartment Size

Minimum Occupancy

Maximum Occupancy

1 Bedroom 1 3

2 Bedroom 2 5

3 Bedroom 3 7

U. UNIT TRANSFER POLICIES, INCLUDING SELECTION OF IN-PLACE RESIDENTS VERSUS APPLICANTS FROM THE WAITING LIST WHEN VACANCIES OCCUR 1) Available apartments will be filled alternately, for appropriate size, by outside applicants on

the wait list and applicants from within the complex who qualify for a move. Exception: residents eligible for an accessible unit will be offered that unit when available even if the list includes outside applicants. If no outside applicant is ready for timely move-in, the unit may be offered to the next current eligible resident. Internal moves require a new lease and related documentation.

2) Residents must live at NAPA PARK HOMES for at least one year prior to placement on the wait list for an internal move unless the move is a result of a reasonable accommodation or a medical necessity. This is to avoid temporary move-ins to wait for a different-size unit.


3) Internal moves may be caused by doctor-verified medical condition, reasonable accommodations and safety. The cost of all internal moves is a resident responsibility with the exception of internal moves as a result of reasonable accommodations. Residents must be given a thirty-day notice of internal moves. Failure to move requires payment of the market rent on the present unit and failure to pay such rent is a material non-compliance with the lease.

NOTE: Residents are required to advise management immediately when family size or other unit-needs change. 4) Residents qualifying for the Wait List for an internal move must register the move-request in

writing with the management office, or may be notified of such qualification by management in writing. The wait-list date is the date the family became eligible for the unit change, such as a change in family size or other condition.

5) Apartment transfers due to personal preferences or roommate disputes are not considered transfer-eligible. The resident wishing a transfer must complete an application when the list is open. The application will be placed on the outside waiting list in chronological order based on the date and time the application is accepted.

6) Criminal/Sex Offender Check will be required of all residents who wish to transfer to another apartment within NAPA PARK HOMES in accordance with guidelines set forth in HUD Notice 2012-11

Management will allow in-house transfers, in the following situations:

A unit transfer for a medical reason, including a reasonable accommodation (this will be verified with a medical practitioner using the Napa Park Homes form);

A transfer from a unit due to renovation of the previous unit.

Napa Park Homes will first assign units to in-place residents who have a demonstrated need for a change in housing before offering units to an applicant on the Waiting List. Requests for transfers that are based on a need for a reasonable accommodation will be provided priority over other requests. Transfers will be provided to persons who have a medical or other verified need because of a disability in the chronological order received. All other transfers will be provided after requests for reasonable accommodations and will occur in chronological order by the date the request was received.

V. ANNUAL RECERTIFICATION/REEXAMINATION-SEX OFFENDER REQUIREMENTS HUD RECOMMENDS THAT AT ANNUAL RECERTIFICATION OR REEXAMINATION, OWNER /AGENTS (O/A S) ASK WHETHER THE TENANT OR ANY MEMEBR OF THE TENANT’S HOUSEHOLD IS SUBJECT TO A STATE LIFETIME SEX OFFENDER REGISTRATION IN ANY STATE PROGRAM IN ANY STATE. O/AS AND PHAS SHOULD VERIFY THIS INFORMATION USING THE DRU SJODIN NATIONAL SEX OFFENDER DATABASE AND/OR OTHER OFFICIAL, FEDERAL, STATE, AND OTHER OFFICIAL FEDERAL, STATE, AND LOCAL RESOURCES AND DOCUMENT THIS INFORMATION IN THE SAME MANNER AS AT ADMISSION. ALL RESIDENTS WILL BE REQUIRED TO COMPLETE AN ANNUAL RECERTIFICATION QUESTIONNAIRE AT ANNUAL RECERTIFICATION AND ANSWER QUESTION AS TO WHETHER THE TENANT OR ANY MEMEBR OF THE TENANT’S HOUSEHOLD IS SUBJECT TO A STATE LIFETIME SEX OFFENDER REGISTRATION IN ANY STATE PROGRAM IN ANY STATE. ADDITIONALLY, MANAGEMENT WILL USE THE DRU SJODIN NATIONAL SEX OFFENDER DATABASE TO DETERMINE WHETHER THE TENANT OR ANY MEMBER OF THE TENANT’S HOUSEHOLD IS SUBJECT TO A STATE LIFETIME SEX OFFENDER REGISTRATION IN ANY STATE PROGRAM IN ANY STATE AND DOCUMENT THIS INFORMATION IN THE SAME MANNER AS AT ADMISSION.


W. POLICY FOR OPENING AND CLOSING THE WAITING LIST FOR THE PROPERTY The wait list may be closed when it contains a year’s worth of applicants, based on current turnover experience, and is re-opened when there is a three-month supply of applicants. A 30-day notice will be posted giving the date and time that the waiting list will be opened. Re-opening and closing of the wait list is posted in the office, communicated to referral groups, and publicly advertised in accordance with the Affirmative Fair Marketing Plan for the property. Applications are not accepted when the wait list is closed. The Wait List is kept chronologically on a form, which states the date and time of the application, Head of Household name, unit size, income level (i.e. ELI, VLI, LI), Need for accessible unit, Comment/Contact, Removed/Rejected Date, Move-in Date, Preference Type. This list is a permanent record. (Note wait list may be closed for only specific unit types i.e. one-bedroom units)

X. GRIEVANCE PROCEDURE Applicants have fourteen [14) days to notify management in writing if they feel that their application was unfairly denied. Management will only reconsider your application if you have any new facts or information that the applicant feels would have an effect on their application. Management will notify the applicant of their final decision within fourteen [14] days of receiving the applicant’s written notice of appeal.

Y. VIOLENCE AGAINST WOMEN ACT (VAWA PROTECTIONS) The VAWA protections apply to families applying for or receiving rental assistance payments under the Property Based Section 8 program. The law protects victims of domestic violence, dating violence or stalking, as well as their immediate family members generally, from being evicted or being denied housing assistance if an incident of violence that is reported and confirmed. The landlord may request in writing that the victim, or a family member on the victim’s behalf, certify that the individual is a victim of abuse and that the Certification of Domestic Violence, Dating Violence or Stalking, Form HUD 91066, or other documentation as noted on the certification form, be completed and submitted within 14 business days, or agreed upon extension date, to receive protection under the VAWA. Failure to provide the certification or other supporting documentation within the specified timeframe may result in eviction or denial of housing assistance.

Z. POLICIES TO COMPLY WITH SECTION 504 OF THE REHABILITATION ACT OF 1973 AND THE FAIR

Housing Act and other relevant civil rights laws and statutes

NAPA PARK HOMES was developed to provide safe, clean and comfortable housing at rental rates appropriate for low-income residents. One of the processes necessary to achieve these goals is to define our selection and occupancy policies for our prospective and current residents. This publication outlines occupancy requirements and procedures.

NAPA PARK HOMES and Napa Valley Community Housing intends to administer these selection criteria in a fair and consistent manner and in accordance with regulations of the U.S. Department of Housing and Urban Development (HUD).


STATEMENT OF NON-DISCRIMINATION It is the policy of NAPA PARK HOMES to comply fully with 24 CFR, Part 1 Title VI of the Civil Rights Act of 1964 Title VIII and Section 3 of the Civil Rights Act of 1968 (As amended by the Community Development Act of 1994), Executive Order 11063, 24 CFR, Part 8 Section 504 of the Rehabilitation Act of 1973, Americans with Disabilities Act; 24 CFR, part 100 et seq Fair Housing Amendments Act; Subpart M of 24 CFR, Part 108 Affirmative Fair Housing Marketing Plan for the property, 24 CFR Part 146 Age Discrimination Act of 1975 and any legislation protecting the individual rights of residents, applicants or staff members, which may subsequently be enacted. Non-Discrimination and Accessibility. NAPA PARK HOMES provides equal housing opportunity for all eligible persons. There is no actual or implied placement based on race, ethnic origin, religious affiliation, sexual preference or marital status. All units are specially designed for accessibility. NAPA PARK HOMES will provide reasonable additional accommodation for disabled persons including permission to use assistive animals when needed. NAPA PARK HOMES will not discriminate because of race, color, sex, religion, age, disabled, disability, marital status, familial status or national origin in the rental of housing or in its use or occupancy. NAPA PARK HOMES will not on account of race, color, sex, religion, age, disabled, disability, marital or familial status or national origin:

Napa Park Homes will not:

1) Deny to any household the opportunity to apply for housing, nor deny to any eligible applicant the opportunity to rent housing suitable to their needs.

2) Provide housing, which is different than that provided for others; subject a person to segregation or different treatment.

3) Restrict a person’s access to any benefit enjoyed by others in connection with the housing program

4) Treat a person differently in determining eligibility or other requirements for admission. 5) Deny a person Access to the same level of services.

6) Deny a person the opportunity to participate in Planning or Advisory group, which is an

integral part of the housing program.

7) Publish or cause to be published an advertisement or notice indicating the availability of housing that prefers or excludes persons.

8) Discriminate against someone because of that person’s relation to or association with another individual; or retaliate against, threaten, or act in any manner to intimidate someone because he or she has exercised rights under the Fair Housing Act.

NAPA PARK HOMES will not automatically deny admission to a particular group or category of otherwise eligible applicants. Each applicant in a particular group or category will be treated on an individual basis in the normal processing routine. NAPA PARK HOMES will seek to identify and eliminate situations or procedures, which create a barrier to equal housing opportunity for all. In accordance with Section 504 of the Rehabilitation Act of 1973, NAPA PARK HOMES will provide reasonable accommodation for individuals with disabilities (applicants or residents). Such accommodations may include changes in the method of administering policies, procedures or services.


STATEMENT OF PRIVACY POLICY

It is the policy of NAPA PARK HOMES to guard the privacy of individuals in accordance with the Federal Privacy Act of 1994 and to ensure the protection of individual records. NAPA PARK HOMES management staff will not disclose any personal information contained in Resident records to any person or agency unless the individual about whom the information is requested has given written consent to such disclosure. This privacy policy in no way limits the management’s capacity to collect such information as it may need to determine eligibility, compute rent or determine an applicant’s suitability for tenancy. Consistent with the intent of Section 504 of the Rehabilitation Act of 1973, any information obtained on disabled or disability will be treated in the same confidential manner.


DEFINITIONS

Disabled Household (i) Has a disability, as defined in 42 U.S.C. 423;

(A) Inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; or (B) In the case of an individual who has attained the age of 55 and is blind, inability by reason of such blindness to engage in substantial gainful activity requiring skills or abilities comparable to those of any gainful activity in which he/she has previously engaged with some regularity and over a substantial period of time. For the purposes of this definition, the term blindness, as defined in section 416(i) (1) of this title, means central vision acuity of 20/200 or less in the better eye with use of a correcting lens. An eye which is accompanied by a limitation in the fields of vision such that the widest diameter of the visual field subtends an angle no greater than 20 degrees shall be considered for the purposes of this paragraph as having a central visual acuity of 20/200 or less.

(ii) Is determined, pursuant to HUD regulations, to have a physical, mental, or emotional impairment that:

(A) Is expected to be of long-continued and indefinite duration, (B) Substantially impedes his or her ability to live independently, and (C) Is of such a nature that the ability to live independently could be improved by more suitable housing conditions; or

(iii) Has a developmental disability, as defined in Section 102(7) of the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6001(8)), i.e., a person with a severe chronic disability that:

(A) Is attributable to a mental or physical impairment or combination of mental and physical impairments; (B) Is manifested before the person attains age 22; (C) Is likely to continue indefinitely; (D) Results in substantial functional limitation in three or more of the following areas of major life activity:

a. Self-care, b. Receptive and expressive language, c. Learning, d. Mobility, e. Self-direction, f. Capacity for independent living, and g. Economic self-sufficiency; and

(E) Reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are of lifelong or extended duration and are individually planned and coordinated.


Extremely Low-Income Family A family whose annual income does not exceed 30% of the median income for the area, as determined by HUD, with adjustments for smaller and larger families, except that HUD may establish income ceilings higher or lower than 30% of the median income for the area if HUD finds that such variations are necessary because of unusually high or low family incomes. [24 CFR 5.603] Elderly Family Elderly family means a family whose head or spouse or sole member is a person who is at least 62 years of age. It may include two or more persons who are at least 62 years of age living together, or one or more persons who are at least 62 years of age living with one or more live-in aides. Independent Student To be classified as an independent student for Title IV aid, a student must meet one or more of the following criteria:

1. Be at least 24 years old by December 31 of the award year for which aid is sought; 2. Be an orphan or a ward of the court through the age of 18; 3. Be a veteran of the U.S. Armed Forces; 4. Have legal dependents other than a spouse (for example, dependent children or an elderly

dependent parent); 5. Be a graduate or professional student; or 6. Be married.

No assistance shall be provided under Section 8 of the United States Housing Act of 1937 (42 U.S.C. 1437f) to any individual who:

1. Is enrolled as a student at an institution of higher education (as defined under section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002));

2. Is under 24 years of age; 3. Is not a veteran; 4. Is unmarried; 5. Does not have a dependent child; 6. Is not otherwise individually eligible, or has parents who, individually or jointly, are not eligible,

to receive assistance under Section 8 of the United States Housing Act of 1937 (42 U.S.C. 1437f); 7. Is not a person with disabilities, as such term is defined in section 3(b) (3) (E) of the United States

Housing Act of 1937 (42 U.S.C. 1437a (b) (3) (E)) and was not receiving assistance under such section 8 as of November 20, 2005.

**Students with disabilities receiving Section 8 as of November 30, 2005 are exempt from the Independent Student restrictions on receiving Section 8 rental assistance. For purposes of determining the eligibility of a person to receive assistance under Section 8 of the United States Housing Act of 1937 (42 U.S.C. 1437f), any financial assistance (in excess of amounts received for tuition) that an individual receives under the Higher Education Act of 1965 (20 U.S.C. 1001 et seq.), from private sources, or an institution of higher education (as defined under the Higher Education Act of 1965 (20 U.S.C. 1002), shall be considered income to that individual, except for a person over the age of 23 with dependent children. Please refer to Appendix A of FR-5036-N-02 for further definitions pertaining to Independent Students and applicable eligibility.


Live In Care Attendant A person who resides with one or more elderly persons, near-elderly persons, or persons with disabilities, and who:

1. Is determined to be essential to the care and well-being of the persons; 2. Is not obligated for the support of the persons; and 3. Would not be living in the unit except to provide the necessary supportive services.

A relative may be a Live In Attendant but must meet all of the above requirements, and sign a statement to that effect. Napa Park Homes will verify this with a physician or recognized health care professional. The sole purpose of a Live In Attendant is to provide the resident with support services and will not qualify for continued occupancy in the event the resident vacates the unit. Napa Park Homes may re-verify the need for a Live In Attendant when necessary. The screening of Live In Attendants at initial occupancy and the screening of persons or Live In Attendants to be added to the resident household after initial occupancy involve identical screening activities as applicants. Live In Attendants must be screened for drug abuse and other criminal activity, including lifetime registration as a sex offender, by applying the same criteria established for screening other applicants. Owner-established screening criteria must also be applied to Live In Attendants. Person with Disabilities Such a person has a disability, as defined in 42 U.S.C. 423;

1. Any adult having a physical impairment that is expected to be of long, continued and indefinite duration, substantially impedes his or her ability to live independently, and is of a nature that such ability could be improved by more suitable housing conditions.

Very Low Income Family A very low-income family is a family whose annual income does not exceed 50 percent of the area median income, as determined by HUD, with adjustments for smaller and larger families. [24 CFR 5.603] Low Income Family A low-income family is a family whose annual income does not exceed 80 percent of the area median income, as determined by HUD, with adjustments for smaller and larger families. [24 CFR 5.603]

__________________________________ ___________________________________ Applicant Signature Date ___________________________________ ___________________________________ Applicant Signature Date ___________________________________ ___________________________________ Management Agent Signature Date

Napa Park Homes 790 Lincoln Avenue

Napa, CA 94558 707-255-3119

July 6, 2011 Date: _______________ Dear: __________________ We regret to inform you that your application for residency at Napa Park Homes has been rejected for the following reason(s): _____ Your income is above the HUD approved income limits for initial occupancy in our very low income apartments,

(Sec 8). _____ Your credit record did not meet our screening criteria. We have enclosed a copy of that report and advise you

that you have the right to contact one of the consumer credit reporting companies responsible for compiling the information for this report, if you have questions or wish to dispute the accuracy or completeness of any of the information contained therein. Those companies include the following:

TRANSUNION EQUIFAX CDI SERVICE CENTER EXPERIAN TRW

2 Baldwin Place P.O. Box 740241 P.O Box 2104 P.O. Box 1000 Atlanta, GA 30374-0241 Allen, TX 75013-2104 Chester, PA 19022 (800) 685-1111 (888) 397-3742

(800) 888-4213 _____ No member of your household is a U.S. citizen or eligible non-citizen and therefore, by HUD regulation,

you do not qualify for this federally assisted housing program.

_____ Your records of current and/or previous tenancy did not meet our screening criteria. _____ You gave false information on your application. _____ We have not been able to verify the following information: ______________________________________ _____ Your household has no rental history, no credit history and no employment history. _____ You have been convicted for crimes that would be considered a real threat to the property or the ability of

other residents to peaceful enjoyment of the premises and/ or including the use, manufacture or distribution of illegal drugs.

_____ OTHER: You have been bypassed twice (2) on our wait list which results in the removal of your application. You have fourteen (14) days from the date of this letter, should you wish to respond in writing or request a meeting to dispute this rejection. Please address your correspondence to: Director of Property Management, Napa Valley Community Housing, 5 Financial Plaza, Suite 200, Napa, CA 94558. Note: Persons with disabilities have the right to request reasonable accommodations in order to participate in any hearing that might be scheduled as a result. If, at some future date, you feel that your situation has changed sufficiently and you feel you would qualify for our housing program, please contact us again. Sincerely, Waitlist Coordinator Napa Park Homes, Inc

RACE AND ETHNICITY DATA Napa Valley Community Housing REPORTING FORM 5 Financial Plaza, Suite 200

Napa, CA 94558

Name of Property & Address (if applicable) or Agency Date

Data Collection for: Wait List Applicant Tenant Unit Applicant

Please list All Members of your Household with Head of Household as #1):

5.

1. 6.

2. 7.

3. 8.

4. 9.

Select One Ethnic Category For Each Household MemberEthnic Categories* HH

#1 2 3 4 5 6 7 8 9

Hispanic or Latino

Not-Hispanic or Latino

Racial Categories* Select All Races that Apply For Each Household Member

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Other (Check “other” for any racial category that is not identified in

one of the five single race categories listed above.)

Other Categories Add Information for Each Household Member

Gender (“M” or “F”)

Age

Disability (“Yes” or “No” for all over 5 yrs. of age)

*Definitions of these categories may be found on the reverse side.

There is no penalty for persons who do not complete the form. Initial here if you choose not to disclose any or some of the race and/or ethnicity information for your household. If you choose not to disclose any of the info, head of household ONLY should sign and date below. Otherwise every adult must sign:

Head of Household Signature Adult Co-Tenant Signature

Adult Co-Tenant Signature Adult Co-Tenant Signature



1 Rev. 02/14/2012 -Based on form HUD-27061-H (3/2009)

Datos de Raza y Grupo Etnico Formulario de informe

Napa Valley Community Housing Five Financial Plaza, Suite 200

Napa, CA 94558

Nombre de la propiedad y Direccion (si aplica) o Agencia Fecha

Información coleccionada es para: Aplicante para la lista de espera Inquilino Aplicante

Por favor de nombrar todas las personas en su familia (la cabeza de familia como #1)

5.

1. 6.

2. 7.

3. 8.

4. 9.

Categorías Etnicas*

Seleccione una categoría étnica para cada persona en su familia

#1 2 3 4 5 6 7 8 9

Hispano o Latino

No Hispano ni Latino Categorías Raciales* Seleccione todas las categorías raciales adecuadas para cada persona en su familia

Indio Americano o Nativo de Alaska

Asiático

Negro o Afroamericano

Nativo de Hawai u otra Isla del Pacífico

Blanco

Otro (Marque "otro" si ninguna de las categorías

raciales se aplican a usted.)

Otros Categorias Agregue Informacion por Cada Persona en la Vivienda

Género (“M”asculino o “F”emeino)

Edád

Incapacidad (“Si” o “No” para todos los

mayores de 5 años de édad)

*Las definiciones de estas categorías pueden encontrarse en el reverso.

No hay penalidad para las personas que no completen el formulario. Favor de Poner sus inicales aquí si opta por no divulgar la raza y/o información de la etnia de su hogar. Si usted opta no revelar la informacion, la cabeza de familia SOLO debe firmar y poner la fecha acontinuacion. De lo contrario todos los adultos deben de firmar.

Cabeza de familia Firmade adulto

Firmade adulto Firmade adulto

Firmade adulto Firmade adulto

Firmade adulto Firmade adulto 1

Rev. 02/14/2012 Based on HUD form 27061-H (3/2009)

EJEMPLO

SOLA

MENTE LLENAR E

N INGLE

S

Instructions for the Race and Ethnic Data Reporting (Form HUD-27061-H) A. General Instructions:

This form is to be completed by individuals wishing to be served (applicants) and those that are currently served (tenants) in housing assisted by the Department of Housing and Urban Development.

Owner and agents are required to offer the applicant/tenant the option to complete the form. The form is to be completed at initial application or at lease signing. In-place tenants must also be offered the opportunity to complete the form as part of the next interim or annual recertification. Once the form is completed it need not be completed again unless the head of household or household composition changes. There is no penalty for persons who do not complete the form.

There is no penalty for persons who do not complete the form. If you choose not to disclose race or ethnicity, initial the refusal statement on the form, then sign and date the form at the bottom. All “completed” or “refused” forms must be kept in the household’s file.

1. The two ethnic categories you should choose from are defined below. You should check one of the two categories.

a. Hispanic or Latino. A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term “Spanish origin” can be used in addition to “Hispanic” or “Latino.”

b. Not Hispanic or Latino. A person not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

2. The five racial categories to choose from are defined below: You should check as many as apply to you.

a. American Indian or Alaska Native. A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

b. Asian. A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam

c. Black or African American. A person having origins in any of the black racial groups of Africa. Terms such as “Haitian” or “Negro” can be used in addition to “Black” or “African American.”

d. Native Hawaiian or Other Pacific Islander. A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

e. White. A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

3. “Other” – You should check “other: for any racial category that is not identified in one of the five single race categories listed in Section 2, above.

2 Rev. 02/14/2012 -Based on form HUD-27061-H (3/2009)

Instrucciones para informar los datos de raza y grupo étnico (Formulario HUD-27061-H) A. Instrucciones generales:

Este formulario debe ser completado por las personas que desean arrendar (solicitantes) y las personas que ya arriendan (arrendatarios) viviendas subvencionadas por el Departamento de Viviendas y Desarrollo Urbano.

Se exige a los propietarios y corredores de bienes raíces que ofrezcan al solicitante/arrendatario la opción de completar el formulario. Se debe completar el formulario al inicio de la solicitud o al momento de firmar el arrendamiento. Los arrendatarios ya ubicados también deben recibir la oportunidad de completar el formulario como parte de la siguiente recertificación pasajera o anual. Una vez que se haya completado, no necesita completarse nuevamente a menos que cambie el jefe de familia o la composición de la familia. No existe sanción para las personas que no completen el formulario. Sin embargo, el propietario o corredor puede colocar una nota en el expediente del arrendatario manifestando que el solicitante/arrendador se rehúso a completar el formulario.

No hay castigo para las personas que no completan el formulario. Si usted opta por no revelar la raza o la etnia, iníciale la declaración de rechazo en el formulario, a continuación, firmar y incluya la fecha en el formulario en la parte inferior. Todos los "completado" o "rechazado" las formas se deben mantener en el archivo de la familia.

1. Se definen debajo las dos categorías étnicas entre las que debe elegir: Debe marcar una de las dos categorías.

1. Hispano o latino. Una persona que sea de Cuba, México, Puerto Rico, Sudamérica y Centroamérica, o de otra cultura u origen español, sin considerar la raza. El término “origen español” puede usarse además de “hispano” o “latino”.

2. No hispano ni latino. Una persona que no sea de Cuba, México, Puerto Rico, Sudamérica y Centroamérica, ni de otra cultura u origen hispano, sin considerar la raza.

2. Se definen debajo las cinco categorías raciales entre las que debe elegir: Debe marcar todas las opciones pertinentes.

1. Indio americano o nativo de Alaska. Una persona con orígenes en cualquiera de los pueblos oriundos de Norteamérica y Sudamérica (incluyendo Centroamérica), y que mantiene afiliación tribal o adherencia comunal.

2. Asiático. Una persona con orígenes en cualquiera de los pueblos oriundos del Lejano Oriente, Sudeste de Asia o el subcontinente indio, incluyendo, por ejemplo a Camboya, China, India, Japón, Corea, Malasia, Pakistán, las Islas Filipinas, Tailandia y Vietnam.

3. Negro o afroamericano. Una persona con orígenes en cualquiera de los grupos raciales negros de África. El término “haitiano” puede utilizarse además de “negro” o “africano”.

4. Nativo de Hawai u otra isla del Pacífico. Una persona con orígenes en cualquiera de los pueblos oriundos de Hawai, Guam, Samoa u otras islas del Pacífico.

5. Blanco. Una persona con orígenes en cualquiera de los pueblos oriundos de Europa, Medio Oriente o Norte de África.

3. “Otro”- Usted debe marcar "otro: para cualquier categoría racial que no se identifica en un de las cinco categorías raciales individuales que figuran en la sección 2, sobre.

1

Rev. 02/14/2012 Based on HUD form 27061-H (3/2009)

Napa Valley Community Housing Adaptable Features for Handicap Accessibility

The following is a list of items that can be adapted for handicap accessibility at our properties:

• Ramps added to access a lower level unit not level with the walkway.

• Vision or peep holes can be added or lowered on the door or can be changed to a larger viewer.

• Install lever door handles to replace any round knobs.

• Door thresholds changed when higher than 1/2" may be reduced to 1/4" or be removed.

• Doors can be removed and/or changed or swing clear hinges installed to increase the width of the door opening. Clear door opening space needs to be 32" wide.

• Environmental controls (thermostats) location changed or installs wireless and/or remote controls.

• Smoke detectors changed to ones that have strobe lights. • Change or add handles or easy grip knobs on cabinets and drawers. • Remove cabinets close to the stove, oven and under the sink. • Lower counter heights to no more than 34" above the finished floor. • Install a stove with controls on the front the appliance. • Grab bars for the shower, tub or toilet areas. • Replace toilet with one that is 17” – 19” from floor to top of seat. • Sliding shower doors and tracks may be removed for easier access

to the tub or shower. • Install single lever handles for the sink and shower knobs. • Handheld shower heads mounted on a vertical bar. • Add shower seating. • Adjust the height of clothes rods/shelves. • Install a door chime with flasher module. • Remove or relocate any protruding or low hanging objects. • Install Braille indicators or labels on fuse boxes, mailboxes,

washer/dryers, etc…

* This list of adaptable items is not all inclusive; requests for any reasonable accommodation/modification will be evaluated on an individual basis.

Napa Valley Community Housing

NOTICE OF RIGHT TO REASONABLE ACCOMMODATION If you have a disability and, as a result of your disability, you need . . . a change in the rules or policies or how we do things that would give you an

equal chance to live here and use the facilities or take part in programs on site,

a change or repair in your apartment or a special type of apartment that would give you an equal chance to live here and use the facilities or take part in programs on site,

a change or repair to some other part of the housing site that would give you an equal chance to live here and use the facilities or take part in programs on site,

a change in the way we communicate with you or give you information, you may ask for this kind of change, which is called a REASONABLE ACCOMODATION. If you can show that you have a disability and if your request is reasonable (*does not pose“ an undue financial or administrative burden”), we will try to make the changes you request. We will give you an answer within 15 working days unless there is a problem getting the information we need or unless you agree to a longer time. We will let you know if we need more information or verification from you or if we would like to talk to you about other ways to meet your needs. If we turn down your request, we will explain the reasons and you can give us more information if you think that will help. If you need help filling out a REASONABLE ACCOMMODATION REQUEST FORM or, if you want to give us your request in some other way, we will help you. You can get a REASONABLE ACCOMMODATION REQUEST FORM at the Napa Valley Community Housing office located at Five Financial Plaza, Suite 200, Napa, CA 94558, or from the Property Manager’s office. NOTE: All information you provide us will be kept confidential and will be used only to help you have an equal opportunity to enjoy your housing and the common areas.

• In simple language this legal phrase means if it is not too expensive and too difficult to arrange