Low Income Housing Tax Credit Rental Application

Complete all questions. Enter N/A when a question does not apply. All co-applicants age 18 or older, including a spouse, must complete a separate application.

Privacy notice: This application collects personal information, including Social Security numbers, for the purpose of determining housing eligibility. Information submitted through this application is transmitted securely and encrypted when stored. Please do not send Social Security numbers or other sensitive information by unsecured email.
1. Household
2. Students
3. Income
4. Assets
5. Housing
6. Other
7. Certify

Household Composition and Status

List the head of household and every person anticipated to live in the unit at least 50 percent of the time during the next 12 months, including temporarily absent members.

Property and Contact Information

Household Members

Choose only one Head of Household. School-age children, including children who are home-schooled, should be identified as full-time students when applicable.

Household Member 1

Stored in the encrypted application record.
Student? *

Full-Time Student Status

Answer each question for the household. Management will verify whether an exception to the full-time student rule applies.

Are all household members full-time students? *
Complete the following questions only when every household member is a full-time student.
Is at least one student receiving assistance under Title IV of the Social Security Act, including AFDC or TANF? *
Does at least one student participate in a Job Training Partnership Act program or another training program funded by a federal, state, or local government agency? *
Are the full-time students married and entitled to file a joint tax return? *
Is the household comprised entirely of a single parent with child or children, and the parent is not a dependent? *
Was at least one student previously under the care and placement responsibility of the state agency administering foster care? *

Income Sources

Report all income received or expected by every household member. Enter gross monthly amounts before taxes or deductions.

Employment

Does any household member receive income from a job or employment? *

Employer 1

Other Income Categories

Does any household member receive Self-Employment? *
Includes app-based driving, e-commerce, video platforms, gig work, contract work, and other business activity.
Does any household member receive Social Security? *
Does any household member receive Supplemental Security Income (SSI)? *
Does any household member receive Pension / Veteran's Administration? *
Does any household member receive TANF / AFDC? *
Does any household member receive Adoption Assistance? *
Does any household member receive Recurring Non-Monetary In-Kind Donations from Outside the Household? *
Does any household member receive Child Support? *
Does any household member receive Alimony? *
Does any household member receive Unemployment Benefits? *
Does any household member receive Educational Financial Assistance? *
Does any household member receive Military Pay? *

Trust, Annuity, Inheritance, Pension, Insurance, or Similar Periodic Payment

Source 1

Recurring Payments from Persons Not Living in the Unit

Source 1

Other Income Source Not Listed Above

Source 1

Asset Sources

Report assets owned by any household member, including assets that do not currently produce income.

Financial and Other Assets

Does any household member have Checking Account? *
Does any household member have Savings / Holiday Account? *
Does any household member have Certificate of Deposit (CD)? *
Does any household member have Direct Express or Other Deposit Card? *
A card where benefits or pay are deposited.
Does any household member have Cash on Hand? *
Does any household member have Cryptocurrency? *
For example, Bitcoin.
Does any household member have Internet-Based Funding? *
For example, GoFundMe.
Does any household member have Stocks, Bonds, Revocable Trusts, or Annuities? *
Does any household member have Money Market or Mutual Funds? *
Does any household member have Treasury Bills? *
Does any household member have Safe Deposit Box? *
Does any household member have Lump-Sum Amounts? *
For example, inheritances, capital gains, lottery winnings, or insurance settlements.
Does any household member have Whole Life or Universal Life Insurance? *
Does any household member have Other Asset Source? *
Does any household member have Federal Refundable Tax Credit Refund Received in the Past 12 Months? *

Non-Necessary Personal Property

Examples include recreational vehicles or boats not needed for daily transportation, expensive jewelry without religious, cultural, or family significance, collectibles, gems, precious metals, antiques, artwork, or equipment not used to generate business income. Do not list ordinary necessary personal property.

Does any household member own non-necessary personal property? *

Property Item 1

Real Property and Disposed Assets

Does any household member own a home, rental property, land, or another capital investment? *
Has any household member disposed of an asset for more than $1,000 below fair market value, given it away, or transferred ownership within the last two years? *
Do not include separation, divorce, bankruptcy, or foreclosure.

Residential History and Screening Questions

Provide three years of housing history. Add as many previous residences as needed to cover the full period.

Residence 1

Screening Questions

Have you ever been evicted from a tenancy? *
Have you ever filed for bankruptcy? *
Have you ever been convicted of a crime? *
Will this be your only place of residence? *
Will you have 50 percent or more physical custody of all minor household members? *
Will you receive rental assistance while living at this community? *
Has your rental assistance ever been terminated for fraud or failure to recertify? *
Do you own any ordinary pets that would move into the community? *
Autumn Lake Apartments is not pet-friendly. Assistance animals related to a disability are evaluated separately from ordinary pet rules.
Do not include medical diagnoses or confidential VAWA details in this field. Contact management to request a confidential process.

Other and Emergency Information

Provide vehicle, emergency contact, and optional application assistance information.

Vehicles

Will the household have a vehicle? *

Vehicle 1

Emergency Information

Application Assistance and Accessibility

Do you need assistance or a reasonable accommodation to complete the application process?
Do you need a unit with accessible features?
Do not include a medical diagnosis. Management may use a separate verification process when legally permitted.
Will an assistance animal related to a disability live in the unit?

Review and Certification

Review the summary and certify the application before submitting.

Certification of Accuracy and Completeness

I certify that all information provided in this rental application is true and complete to the best of my knowledge and understand that this information will be used to verify income eligibility for the Low Income Housing Tax Credit program.

I understand and agree that the owner or management agent may use this information to investigate creditworthiness through credit reporting, criminal screening, and landlord verification according to applicable law and written screening standards.

I understand that an applicant who purposefully falsifies, misrepresents, withholds, or submits inaccurate or incomplete information related to program eligibility may not be considered for housing. If a material misrepresentation or omission is discovered after tenancy begins, action may be taken as allowed by law and governing documents.

Under penalty of perjury, I certify that I have read this statement and grant consent for the release of information to appropriate third parties as needed for verification purposes.

This application is not a lease, a guarantee of housing, or a guarantee of rental assistance. Final approval depends on verification and compliance with the property's Tenant Selection Plan and program requirements.

Separate adult applications: Every co-applicant age 18 or older, including a spouse, must submit a separate application.

Your New Home Starts Here

Complete the First Cumberland Properties LIHTC application and take the next step toward Autumn Lake Apartments.

Questions Before Applying?

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