Properties |
Calkins |
All Others |
Family of 1 |
$46,080 |
$39,480 |
Family of 2 |
$52,640 |
$44,400 |
Family of 3 |
|
$65,760 |
Family of 4 |
|
$49,300 |
Family of 5 |
$59,200 |
$71,040 |
Family of 6 |
|
$76,320 |
Managing Agent requires COPIES of the following documentation for ALL HOUSEHOLD MEMBERS and Application Fee
- Social Security Cards
- Certified Birth Certificates (Certified copies, not complimentary copies from the hospital) or CIBs for Native Americans.
- Valid State-Issued IDs (for 18 years of age or older). Must be Colorado IDs at time of Lease signing.
- $40.00 Application fee for each adult- Cashiers Check or Money Order (NO CASH)
BE CERTAIN TO SIGN AND DATE WHERE REQUIRED
Once your completed Application is received, you will be placed on the waiting list by the
date and time the Application is received. Submitting an application does not guarantee
housing.
Complete the Application and answer all questions. If the questions do not apply to you,
state either NO, NONE or N/A. Every blank must be complete. Incomplete Applications Will
Be Withdrawn.
Federal Law preempts State Laws when it comes to the use of Medical Mari juana,
Initial e, Medical Mari juana users are prohibited into the Public Housing and the Housing Choice
v vu\.ucr (Section 8) Programs, as well as any wtlts owned or managed by the Housing Authority of the
County of Montezuma.
A. Federal Drug Laws
Marijuana is categorized as a Schedule I substance under the Controlled Substances Act
(CSA). See 21 US. C. 801 et seq. The Manufacture, distribution, or possession of
mari juana is a federal criminal offense, and it may not be legally prescribed by a physician
for any reason. See 21 USC. 841 (a)(]); 812(b)(l)(A)-(C)
By signing below, I/We acknowledge and understand that the use of controlled substances for recreational
use or medicinal use is prohibited on all Housing Authority of the County of Montezuma property and the
use, possession and distribution of a controlled substance will be a deciding factor in the decision to
provide housing assistance to you or anyone in your household.
"The information regarding race, ethnicity and sex designation solicited on this application is requested in order
to assure the Federal Government that Federal Laws prohibiting discrimination against tenant Applications on
the basis of race, color, national origin, religion, sex, familial status, gender identity (including gender
expression), sexual orientation, age and disability are complied with. You are not required to furnish this
information but are encouraged to do so. This information will not be used in evaluating your Application or to
discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the
race, ethnicity, and sex of the individual applicants on the basis of visual observation or surname."
Submitting an application does not guarantee housing
In accordance with the regulations at 24 CFR 5.856 and 5.905, O/As and PHAs must
Initial perfonn necessary criminal history background checks to determine if any applicant, or member of
an applicant's household, is subject to a lifetime registration requirement under a State or Federal
sex offender registration program. This check must be carried out with respect to the State in
which the housing is located and with respect to States where applicant and members of the
applicant's household are known to have resided.
Please be advised that it is your responsibility to notify the Housing Authority in writing, of any
CHANGE OF MAILING ADDRESS. We must be able to contact you by your current mailing
address at which time a Nationwide Criminal Background Check and Credit Report will be
conducted on all applicants over the age of 18.
By qualifying and accepting a unit, you agree to pay a Security Deposit set forth for said unit. The managing Agent has the right to keep said deposit (tenant would forfeit deposit) if prospective Tenant does not give a minimum of a 30-day notice that they will not be moving into said unit.
if the proper notice is given to the Managing Agent, Managing Agent has 30 calendar day to return the Security Deposit, less any administrative fees, to the address provided.
I certify that the information present on this form is true and accurate to the best of my/our knowledge. The undersigned further understands that providing false presentations herein constitutes an act of fraud. False, misleading or incomplete information will result in the denial of Application.
Move-in Application
The information on this form is needed to certify your household. Please complete this entire form and leave no blanks. If
there are any questions that you do not understand, please call the apartment manager. Thank you for your cooperation.
part 1 household composition
hh mbr 1
hh mbr 2
hh mbr 3
hh mbr 4
hh mbr 5
hh mbr 6
part 2 current/previous residency
part 3 household income
does your household have income, assistance, or benefits from the sources listed below?
part 4 current employment information (please attach a separate form for additional employment, if needed)
part 5 previous employment information (not required for retired persons)
part 6 student status certification
Students include individuals attending public or private elementary schools, middle or junior high schools, senior high
schools, colleges, universities, technical, trade or mechanical schools. Students do not include individuals participating in
on-the-job training or correspondence courses
please choose one option below that best describes your household
part 7 household asset information
Signatures
Under penalties of perjury, I certify that the information presented on this form is true and accurate to the best of
my/our knowledge. The undersigned further understands that providing false representations herein constitutes
an act of fraud. False, misleading, or incomplete information will result in the denial of application or termination
of the lease agreement.
All household members ages 18 or over must sign and date.