Jonah Affordable Housing Organization Rental Application Form

Jonah Affordable Housing Organization Rental Application Form
Enter today's date: (MM/DD/YYY)
Enter today's time

Hour Minutes

AM/PM Option
House is located in ______________________.
City
This is a preliminary application for a _______.
- Head of Household
  
  PrefixFirst NameMiddle NameLast Name
- Social Security #
  Example: 123-456-7890
- DOB (Date of Birth)
  MM/DD/YYY
- Age
- Email
- Cell Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Work Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Address for Mailing
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Is the residential address different from the mailing address?
- Residential Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Alternative Contact Name
  
  First NameLast Name
- Alternative Contact Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Children (List only if living with you.)
- Are you or your spouse handicapped or disabled?
- Marital Status:
- Spouse's Name:
- Spouse's Age:
- Spouse's Social Security #
  Example: 123-456-7890
- Spouse's DOB (Date of Birth)
  MM/DD/YYY
- Spouse's Email
  example@example.com
- Spouse's Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Spouse's Current Occupation
  Please enter your occupation.
- Spouse's Length of Time in Position
  Please enter the number of months/years.
- Spouse's Current Salary
- Spouse's Current Employer's Name
  
  First NameLast Name
- Spouse's Employer's Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Please explain why you are leaving your present housing and seeking housing with JAHO?
- Length of time at your current address (in item A, number 3): Months/Years .
- Name of present Landlord
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Landlord's Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Current Occupation blanks ? Length of time in position? blank .
- Current Employer's Name
  
  First NameLast Name
- Employer's Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Employer's Email
  example@example.com
- Employer's Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Current Salary
- Other Household Income
- Monthly Housing Expenses
- Other Expenses: Payments
- Monthly Housing Expenses Total
- Other Expenses: Payments Total
- Are you Section 8 approved?
- If yes, in what County?
- Have you ever been evicted?
- Have you ever failed to timely pay rent?
- Have you ever filed for bankruptcy?
- Have you ever been convicted of a felony?
- Have you ever been convicted as a sex offender?
- Have you ever been convicted of a drug-related offense?
- Please explain below if you checked "yes" for any items above.
- List three (3) people not related to you by blood or marriage that we may contact as references.
- Read and check ALL below in agreement: I, the applicant, agree with the following statements
- Date
  
  MonthDayYear
  Date
- Applicant's Name
- Signature of Applicant
- Co-Applicant's Name
- Signature of Co-Applicant's Signature
Should be Empty: