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 _______.*

1-bedroom2-bedrooms3-bedrooms4-bedrooms
- 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.
- Work Phone Number*
  Please enter a valid phone number.
- Address for Mailing*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Is the residential address different from the mailing address?*
  
  YesNo
- 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.
- Children (List only if living with you.)*
- Are you or your spouse handicapped or disabled?*
  
  YesNo
- Marital Status:*
  
  SingleSeparatedMarriedDivorced
- 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.
- 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.
- 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.
- Current Salary*
- Other Household Income*
- Monthly Housing Expenses*
- Other Expenses: Payments*
- Monthly Housing Expenses Total*
- Other Expenses: Payments Total*
- Are you Section 8 approved?*
  
  YesNo
- If yes, in what County?*
- Have you ever been evicted?*
  
  YesNo
- Have you ever failed to timely pay rent?*
  
  YesNo
- Have you ever filed for bankruptcy?*
  
  YesNo
- Have you ever been convicted of a felony?*
  
  YesNo
- Have you ever been convicted as a sex offender?*
  
  YesNo
- Have you ever been convicted of a drug-related offense?*
  
  YesNo
- 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*
  
  I/We certify that all the information above is completed, correct and true to the best of my/our knowledge.I/We understand that false or misleading information may result in the rejection of my/our application.I/We also understand that completion of this application in no way guarantees that I/we will receive rental housing. I/We authorize you to conduct an employment, background and/or credit check concerning my/our application and to verify all references.
- Date*
  
  MonthDayYear
  Date
- Applicant's Name*
- Signature of Applicant*
  
  Powered by Jotform SignClear
- Co-Applicant's Name
- Signature of Co-Applicant's Signature
  
  Powered by Jotform SignClear
Should be Empty: