Delton Manor Apartments

  • Delton Manor Apartments ~ Bemidji, MN

  • Image field 248
  • Format: (000) 000-0000.

  • All applicants, age 18 or older, other than co-head or spouse, are required to complete a separate application. Any applicant who purposefully falsifies, misrepresents or withholds any information related to program eligibility or submits inaccurate and/or incomplete information on this application or during the interview may be rejected for housing. All questions must be answered;

    List the Head of Household and all other persons who will be living in the unit. Give the relationship of each family member to the head. Each household member age 18 years or older must sign this application. 

     

  • Applicants Date of Birth*
     - -
  • Is there any additional applicants? (include everyone that will reside in unit)*
  • 2nd Applicants Date of Birth*
     - -
  • Is there any additional applicants? (include everyone that will reside in unit)*
  • 3rd Applicants Date of Birth*
     - -
  • Is there any additional applicants? (include everyone that will reside in unit)*
  • 4th Applicants Date of Birth*
     - -
  • Is there any additional applicants?*
  • 5th Applicants Date of Birth*
     - -
  • Is there any additional applicants?*
  • 6th Applicants Date of Birth*
     - -
  • Race of Head of Household*
  • Ethnicity of Head of Household*
  • Are you a Non-Citizen Student?*
  • Are you a United States Citizen?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Start Date
     - -
  • Salary Frequency
  • Format: (000) 000-0000.
  • Start Date
     - -
  • Salary Frequency

  • Household Income Information

    Do you receive or expect to receive...
  • Wages, salaries (includes overtime, tips, bonuses, commissions, self-employment?
  • Does any member work for someone who pays them in cash?
  • Regular pay for a member of the armed forces?
  • Welfare or disability benefits (Examples: MFIP, SSI, etc)?
  • Worker's compensation?
  • Unemployment benefits or severance pay?
  • Child support? (if court ordered, include even if it is not being received)
  • Alimony?
  • Social Security Payments (include unearned income of minor children)?
  • Pensions (PERA, railroad, etc)?
  • Retirement benefits?
  • Death benefits?
  • Annuities or life insurance dividends?
  • Lump sum payment(s) (i.e., inheritance, insurance settlements, lottery winnings, capital gains)?
  • Net income from rental property?
  • Regular cash contributions or gifts from individuals not living in the unit?

  • Household Assets

    Do you have money held in.....
  • Checking Accounts?*
  • Savings Accounts?*
  • Stocks?*
  • Capital Investments?*
  • Bonds?*
  • Trusts?*
  • Securities?*
  • Insurance Settlements?*
  • 401K?*
  • IRA/KEOGH Accounts?*
  • Certification of deposits?*
  • Pension/retirement funds?*
  • Money Market Funds?*
  • Treasury Bills?*
  • Safety Deposit Box?*
  • Cash card to receive gov benefits?*
  • Do you now own real estate?*
  • Do you hold a contract for deed?*
  • Do you have any coin collections, antique cars, gems/jewelry, stamps or any other items held as an investment (wedding rings and personal jewelry do not count)?*
  • I/We hereby certify that I/We have or have not sold or disposed of any assets for less than Fair Market Value during the two year (24 month) period preceding the date of this application?*

  • HOUSEHOLD ALLOWANCE INFORMATION

    Do you expect to incur any of the following expenses:
  • Child care which enables you or another household member to work, go to school or to seek employment?*
  • Attendant care for a handicapped or disabled household member so that an adult household member can work, seek employment or go to school?*
  • Medicare premiums?*
  • Other medical insurance premiums?*
  • Outstanding medical bills on which you are currently paying?*
  • Cost of assistive devices for a handicapped or disabled household member?*
  • Do you receive medical assistance through a public assistance agency/program?*
  • Do you expect to have any additional medical expenses during the next twelve (12) months?*

  • Miscellaneous

    The following questions pertain to yourself and every member of your household who will occupy the unit.

  • When? Name of development

  • * How did you hear of this housing development?

  • Signatures

  • I/We understand the information in this application will be used to determine eligibility for Section 8 housing assistance and that

    this information will be verified. I/We understand that any false information may make me/us ineligible for a unit.

    I/We certify that all information given in this application is true, complete and accurate. I/We understand that if any of this information is false, misleading or incomplete, management may decline our application or, if move-in has occurred, terminate my/our lease agreement.

    I/We understand that any action(s) by myself/ourselves or my/our household members, whether verbal or non-verbal, that harass, intimidate, threaten or are perceived by management to harass, intimidate or threaten the health or safety of the management stall or interfere with the management of the property is grounds for management to decline my/our application for housing.

    I/We understand that if I/we or any member of my/our household suggest or offer bribes of money, material goods, etc., to the management staff responsible for determining either my/our placement on the waiting list of processing of my/our housing application is grounds for management to decline my/our application for housing.

    I/We authorize management to make any and all inquiries to verify this information, directly or through information exchanged now or later with rental and credit screening services, and to contact previous and current landlords or other sources for credit and verification information which may be released to appropriate Federal, state or local agencies.

    If my/our application is approved, and move-in occurs, I/we certify that only those persons listed in this application will occupy the unit, that it will be my/our only residence, and that there are no other persons for whom I/we have, or expect to have, responsibility to provide housing.

    I/We agree to notify management in writing regarding any changes in household address, telephone numbers, income and household composition.

    My/Our signature(s), as indicated below, acknowledge that I/we have read and completed each section of this rental application, as applicable.

    All household members age 18 or older sign below:

  • Date*
     / /
  • Date
     / /

  • HUD Form 92006

  • Supplemental and Optional 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.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Check YES if you choose NOT to provide the emergency contact information*
  • Format: (000) 000-0000.
  • Reasons to contact additional contact person: (Check all that apply)
  • Date*
     / /

  • RHR RENTAL HISTORY REPORTS

    General Consent Form - Each applicant 18 + over MUST complete a consent form
  • Date of Birth*
     / /
  • Format: (000) 000-0000.

  • I/We authorize Rental History Reports (RHR) and/or the above named company to do a complete investigation of all information provided within my application for residency. I/We have personally filled in and/or reviewed all information contained within the application. I/We understand failure to complete these documents completely and truthfully may result in denial and/or forfeit of deposit. A complete investigation may include any or all of the following: Credit Report, Verification of Employment and Income, Criminal Record Search, Rental History References (including MPHA), Unlawful Detainer/Eviction Investigation, Identity Trace, Sex Offender Search, Terrorism Search, Check Writing History, and Personal Interviews with all provided references. The source of the information may come from, but is not limited to: credit bureaus; banks and other depository institutions; current and former employers; federal or state records including State Employment Security Agency records, county or state criminal records, count agencies as it relates to the applicant's eligibility, non-eligibility and/or benefit amounts received by the tenant, or other sourcesas required. It is understood that a photocopy or facsimile copy of this form will serve as authorization. I/We understand that I/We have a right tomake a written request within 30 days to receive information pertaining to this report if I/We are not accepted based upon information containedinthe report. I/We authorize RHR to produce to the credit granter Federal and State records of employment and income history, including State Employment Security Agency records. This authorization continues in effect for one (1) year unless limited by state law, in which case, the authorization continues in effect for the maximum period, not to exceed one (1) year.

  • Date*
     / /
  • Is there additional applicants over 18 years of age? If so they must also complete a background check RHR General Consent Form

  • RHR Rental History Reports

    General Consent Form - Each applicant 18+ over must complete a consent form
  • Date of Birth*
     / /
  • Format: (000) 000-0000.

  • I/We authorize Rental History Reports (RHR) and/or the above named company to do a complete investigation of all information application for residency. I/We have personally filled in and/or reviewed all information contained within the application. I/We understandfailureto complete these documents completely and truthfully may result in denial and/or forfeit of deposit. A complete investigation mayincludeorallof any the following: Credit Report, Verification of Employment and Income, Criminal Record Search, Rental History References (including MPHA), Unlawful Detainer/Eviction Investigation, Identity Trace, Sex Offender Search, Terrorism Search, Check Writing History, and PersonalInterviews with all provided references. The source of the information may come from, but is not limited to: credit bureaus; banks and other depository institutions; current and former employers; federal or state records including State Employment Security Agency records, county or state criminal records, count agencies as it relates to the applicant's eligibility, non-eligibility and/or benefit amounts received by the tenant, or other sources as required. It is understood that a photocopy or facsimile copy of this form will serve as authorization. I/We understand that I/We have a right to make a written request within 30 days to receive information pertaining to this report if I/We are not accepted based upon information contained in the report. I/We authorize RHR to produce to the credit granter Federal and State records of employment and income history, including State Employment Security Agency records. This authorization continues in effect for one (1) year unless limited by state law, in whichthe case, authorization continues in effect for the maximum period, not to exceed one (1) year.

  • Date*
     / /
  • Is there additional applicants over 18 years of age? If so they must also complete a background check RHR General Consent Form*

  • RHR Rental History Reports

    General Consent Form - Each applicant 18 + over MUST complete a consent form
  • Date of Birth*
     / /
  • Format: (000) 000-0000.

  • I/We authorize Rental History Reports (RHR) and/or the above named company to do a complete investigation of all information provided within my application for residency. I/We have personally filled in and/or reviewed all information contained within the application. I/We understand failure to complete these documents completely and truthfully may result in denial and/or forfeit of deposit. A complete investigation may includeor any the following: Credit Report, Verification of Employment and Income, Criminal Record Search, Rental History References (including MPHA), Unlawful Detainer/Eviction Investigation, Identity Trace, Sex Offender Search, Terrorism Search, Check Writing History, and Personal Interviews with all provided references. The source of the information may come from, but is not limited to: credit bureaus; banks and other depository institutions; current and former employers; federal or state records including State Employment Security Agency records, county orstatecriminal records, count agencies as it relates to the applicant's eligibility, non-eligibility and/or benefit amounts received by the tenant, or othersourcesas required. It is understood that a photocopy or facsimile copy of this form will serve as authorization. I/We understand that I/We have a right to make a written request within 30 days to receive information pertaining to this report if I/We are not accepted based upon information contained in the report. I/We authorize RHR to produce to the credit granter Federal and State records of employment and income history, including State Employment Security Agency records. This authorization continues in effect for one (1) year unless limited by state law, in which case, the authorization continues in effect for the maximum period, not to exceed one (1) year.

  • Date*
     / /
  • Is there additional applicants over 18 years of age? If so they must also complete a background check RHR General Consent Form*

  • RHR RENTAL HISTORY REPORTS

    General Consent Form - Each applicant 18+ over MUST complete a consent form
  • Date of Birth*
     / /
  • Format: (000) 000-0000.

  • I/We authorize Rental History Reports (RHR) and/or the above named company to do a complete investigation of all information provided within my application for residency. I/We have personally filled in and/or reviewed all information contained within the application. I/We understand failure to complete these documents completely and truthfully may result in denial and/or forfeit of deposit. A complete investigation mayincludeorallof any the following: Credit Report, Verification of Employment and Income, Criminal Record Search, Rental History References (including MPHA), Unlawful Detainer/Eviction Investigation, Identity Trace, Sex Offender Search, Terrorism Search, Check Writing History, and Personal Interviews with all provided references. The source of the information may come from, but is not limited to: credit bureaus; banks and other depository institutions; current and former employers; federal or state records including State Employment Security Agency records, county orstatecriminal records, count agencies as it relates to the applicant's eligibility, non-eligibility and/or benefit amounts received by the tenant, or othersourcesas required. It is understood that a photocopy or facsimile copy of this form will serve as authorization. I/We understand that I/We have a right to make a written request within 30 days to receive information pertaining to this report if I/We are not accepted based upon information contained in the report. I/We authorize RHR to produce to the credit granter Federal and State records of employment and income history, including State Employment Security Agency records. This authorization continues in effect for one (1) year unless limited by state law, in which case,the authorization continues in effect for the maximum period, not to exceed one (1) year.

  • Date*
     / /
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