I. APPLICANT INFORMATION
II. Accommodations and emergency contact
III. Household Income
IV. Housing Assets
V. Signatures/Certification of True and Correct Information
By completing and returning this application, you will automatically be placed on a waiting list for North Memphis Community Development Federally Funded Permanent Housing Program:
I certify that all that information above is complete, correct and true to the best of my knowledge. I understand that false or misleading information may result in the rejection of my application. I also understand that completion of this application in no way guarantees me that I receive rental housing. Further, I give permission to check any and all my information and/or references contained herein, including but not limited to employers and landlords; and further, I also give permission to check my credit rating and the credit information contained herein either directly or through a credit reporting agency.
Please note: By signing this application, you are allowing the Supportive Housing Staff to complete any needed checks listed below. Please be sure you have answered all questions. Otherwise, we will be unable to process your application.
WARNING: Section 1001, of Title 18 of the U.S. code, makes it a criminal offense to make willful false statements or misrepresentation to any department or agency of the United States as to any matter within its jurisdiction. Applicants will not be discriminated against on the basis of race, color, religion, sex or national origin.