Application Duck Pond Step 1 of 3 33% PRE APPLICATION for THE DUCK PONDDirections to Applicant: Answer all questions on this application. Enter “None” or “N/A” for those questions which do not apply to you. Include all members who you anticipate will occupy the unit any time during the next 12 months. Please request additional paper to record additional information if there isn’t enough room for an entry. At the time of application please provide verification of birth dates, verification of family composition, and social security numbers for all household members. All adults must sign/date the application. Failure to provide information to the best of your belief and knowledge may result in rejection.CONTACT INFORMATIONUpdate with the office when you have a change.Current Mailing AddressStreet AddressCityStateZipCurrent TelephoneCellHomeWork FAMILY COMPOSITIONName ALL People to Occupy Apt.Full Name% of time child will live in homeDate of BirthRelation to HeadSex (not required)Social Security NumberFull or Part-time Student (K-12, college, technical, etc.) Add RemoveDo you expect a change in family size in the future? Yes No Please, explain change and provide expected date of change:Are there any temporarily absent family members? Yes No Please, provide name, reason and date of return:Would you or any members of your household benefit from a disabled/accessible unit? Yes No Please, explain:How did you hear about us? How much is your annual income? Have you ever been charged and/or convicted of a felony? Yes No Please, explain:Have you ever been charged and/or convicted of a misdemeanor? Yes No Please, explain: BEDROOM SIZE & AREA SELECTIONApplicants must meet all eligibility requirements including elderly and/or disabled. Income Guidelines are followed and published annually. 1 BR Minimum of 1 household members, Maximum of 2 household members CREDIT AND CRIMINAL RELEASE AND SIGNATUREI/We, the submitter/s, state that I/we have read and answered fully and truthfully each of the preceding questions for all members of the Household who are to occupy the unit in the above Section 8 / Section 42 rental development for which application is made, all of whom are listed above. I/We understand that providing false information or making false statements may be grounds for denial of my/our application. I/We further understand and authorize that as part of the application process HERITAGE APARTMENTS AND/OR HARMONY MANAGEMENT will conduct a credit, criminal and sex offender screening. All inquiries will be made to verify this information, either directly or through information exchanged now or later with rental and credit screening service companies and to contact previous and current landlords or other sources for credit and verification confirmation which may be released to appropriate Federal, State or local agencies. I/we will be required to authorize verification of my/our income and assets. I/We understand that all of the above information must be obtained in order to establish my eligibility for the Section 8 / Low Income Housing Tax Credit Programs. If you have a disability and need a reasonable accommodation in order to participate in the application process or to make effective use of the housing program, you have the right to request such accommodation. A reasonable accommodation is a change, exception, or adjustment to a program, service, building, dwelling unit or workplace that will allow a qualified person with a disability to participate fully in a program, take advantage of a service, live in a dwelling or perform a job. 21398