2 - Bulk Vacancy RSVPs

Concatenated File Name + SSN + DOB + RSVP VL

Instructions

Office Only - HWs Staff Code

Applicant leave this field BLANK.

Submission Date and Time

Hour MinutesAM/PM Option

Vacancy RSVP entered by HWs staff

SSN Widget

DOB Widget

Pick ONE of the three options below.

If you did not personally receive a notice about this vacancy, your responses will be ignored.

Please indicate your availability for an interview.

The consequences to providing incomplete - or false - information on this form

Carefully enter the Control Code next to your name in the Notice you received

TYPE THE CONTROL CODE EXACTLY, ELSE YOU MIGHT NOT BE OFFERED AN INTERVIEW

Your First Name - No Nickhames! Enter ONLY the first name, not your middle or last names

Do you have a middle name?

Your Middle Name - No Initials! We need your whole middle name

Note: We will reject your submission if you only provided your Middle Initial.

If you have a Middle Name, we must have your full Middle Name. (Leave this field blank if you have no middle name.)

Also: if you entered your "Last name" in the field for "First name" we will reject your submission.

Also: if you entered your "First Name" in the field for "Last Name" we will reject your submission.

All your LEGAL LAST Names

Enter your Full Name again, EXACTLY AS YOU TYPED IT ABOVE

First NameComplete Middle NameAll Legal Last Names

Did you include your complete middle name and all last names you have ever had? If not, go back and fill in what is missing.

Mother's LAST NAME when she was a child

If you don’t know your mother’s last name when she was a child, enter “hw1”

CRIMINAL RECORD CHECKS require us to collect 1. Your FULL Middle Name if you have one (no initials), 2. ALL Last Names, 3. Your FULL SSN or ITIN, and 4. Your Mother's LAST NAME WHEN SHE WAS A CHILD.

In the section below, check the waitlist that matches what you see in the notice you received.

Do not check a waitlist if that waitlist is not listed in your letter.
If you received multiple notices about vacancies, you must fill out this form once for each notice.

Stop right now and examine the notice you received for this vacancy; have you missed the deadline to respond?

Vacancy: Jackson Commons 2BR 80% AMI

Vacancy: Jackson Commons 2BR 110% AMI

Vacancy: BLANK

The Waitlist you checked just above MUST match the waitlist you see in your notice.

I understand IT IS ILLEGAL for me to check a waitlist above IF I DID NOT RECEIVE A LETTER THAT CLEARLY STATES I AM ON THAT LIST AND BEING CONSIDERED FOR A VACANCY. (If you made a mistake and checked a waitlist above that you did not receive a notice about, go back up and uncheck that list!

Does the Head of Household (that's you) have an SSN or an ITIN?

Enter your COMPLETE SSN or ITIN

Your Date of Birth as MM-DD-YYYY

Date

Gender (Female, Male. If Transgender, please use one of these two choices to indicate your Destination Gender)

Ethnicity

Race

Requires FULL Wheelchair Access

Reasonable Accommodations

Career Stage

Any veterans in the household?

Do you have a permanent mobile voucher or other long term rental assistance?

Type of voucher or rental assistance

Does the Head of Household have a CORI?

Is anyone in the household subject to a lifetime sex offender registration in any state?

Any Pets?

If you have pets, how many?

If you have two pets, write "2" - don't write "Two"

Pets: describe the breed, size, color, and weight. DO NOT use quote marks (")

Is/Are your pets:

Document Date Stamp - MUST match the Date-Time Stamp on Application

Date set automatically

Number of household members 18 yrs and older - INCLUDING YOURSELF

We assume these adults will be moving with you.

Number of household members who are 17 yrs and younger - ENTER "0" if no children

We assume these children will be moving with you.

Total Household Size (all adults and children)

I understand and affirm that providing incorrect or false reports of my annual income is grounds for removal from this waitlist.

HOUSEHOLD INCOME

Because we may call you soon, we need to know the TRUE ANNUAL INCOME FOR THE ENTIRE HOUSEHOLD AS OF THIS MOMENT.

This will tell us whether or not we can move you into this particular vacant unit.

We will confirm your income by checking all your income sources.

In the field below, please provide an accurate account of your annual income, so that you don't waste your time and ours during an interview.

Total YEARLY Income for Entire Household

Do any other Household Members have a CORI?

Desired # of Bedrooms (Pick only ONE OPTION) Your household must be able to put 1 or 2 persons in each Bedroom.

Does any member of household have a documented disability?

Your Current Housing Status

Have you recently been displaced?

HoH Primary Phone Number

HoH Secondary Phone Number

HoH Email Address (if you want a receipt for this Update)

Preferred Method of Contact

LIVING Address Line 1 - include Apartment #

LIVING Address City

LIVING Address State or US Territory

LIVING Address Zip Code

Is your MAILING ADDRESS the same as the address you wrote above?

MAILING Address Line 1 - include Apartment #

MAILING Address City

MAILING Address State or US Territory

MAILING Address Zip Code

Name of Your Emergency Contact

First NameLast Name

Relationship to Emergency Contact to you (friend, relative, minister, etc)

Phone Number of Emergency Contact

Please enter a valid phone number.Format: 000-000-0000.

Email Address of Emergency Contact

example@example.com

Mailing Address of Emergency Contact

Address Line 1 including Apt #

Street Address Line 2

CityState

Zip Code

Are you claiming any of these Preferences or Priorities? They may not apply to this particular vacancy, but we want to know anyway.

Sign here, using the mouse or your finger.

AMI Category

Status

Latest Outcome

We rejected your update because

History and Notes

Vacancy Interview Response Form