Development Application

APPLICANTS STATEMENT
1. This application is taken and subject to the approval of the owner.

2. Before approval to occupy the unit, I authorize the owners to:

a. Complete a credit check on the applicant and any adult household members 18 years and older.

b. Complete a criminal background check on the applicant and any adult household members 18 years and older.

c. Complete reference checks on the applicant and any adult household memebrs 18 years and older

3. I/We certify that the information given to the Northwest Minnesota Multi-County HRA in this application is accurate and complete to the best of my/our knowledge and belief. If I/We falsify information on my/our application, it will be denied.

4. I/We understand the lease is made on the strength of this application and may be terminated at any time, at the owner's option, if any information herein is false.
Head of Household's Signature*

Clear
Date*

MonthDayYear
Date
All adult household members 18 years and older must sign the application. Do you have additional adult members that need to sign?*

YesNo
How many additional adults need to sign?*
Additional Adult Member's Signature*

Clear
Date*

MonthDayYear
Date
Additional Adult Member's Signature*

Clear
Date*

MonthDayYear
Date
Submission Date

MonthDayYear
Date
Submission Time

Hour Minutes

AM/PM Option

HEAD OF HOUSEHOLD