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Hotel Berry Application Form

Hotel Berry Application Form

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Published by melissacorker

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Published by: melissacorker on Mar 22, 2012
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11/06/2013

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THE
STUDIOS
AT
HOTEL
BERRY
Application
Instructions
Dear
Applicant,
Thank
you
for
your
interest
in
applying
for
housing
at
The
Studios
at
Hotel
Berry.

Please
complete
the
attached
application
and
return
to
us
at
either
of 
the
following
addresses:
The
Shasta
Hotel
Sacramento
Housing
and
Redevelopment
Agency
1017
10
th
Street
801
12
th
Street
Sacramento,
CA

95814
Sacramento,
CA
95814
Applications
will
be
reviewed
for
income
eligibility.
Applications
that
do
not
meet
the
minimum
income
or
exceed
the
maximum
income
qualifications
will
not
be
processed.
Each
person
may
only
submit
one
application.
Applications
may
be
mailed
or
hand
delivered.
Applicants
must
meet
the
following
eligibility
criteria:
Monthly
income
must
be
a
minimum
of 
two
times
the
monthly
rent.
(Minimum
income
requirements
do
not
apply
to
Section
8
Voucher
Holders.
Income
and
Rents
subject
to
change.)
The
maximum
occupancy
is
one
(1)
person.

All
Applicants
are
subject
to
the
Resident
Selection
Policy
including
credit
and
criminal
background
checks
and
third
party
income
and
asset
verification
to
determine
the
occupants
combined
annual
income
in
accordance
with
the
Housing
Tax
Credit
Program.

Thank
you
again
for
your
interest
in
The
Studios
at
Hotel
Berry
and
we
look
forward
to
receiving
your
application.
Number
of 
Units
%
of 
Area
Median
IncomeMaximum
Income
Rents
as
of 
01/01/2012
10
Studio
Units
(MHSA
Restricted)
20%
$10,660 $249
1
Studio
Unit
30%
$15,990 $399
11
Studio
Units
35%
$18,655 $466
70
Studio
Units
40%
$21,320 $533
12
Studio
Units
45%
$23,985 $599
For
more
information,
please
call
916
448
7510.
Sincerely,
THE
JOHN
STEWART
COMPANY
TDD
Telephone
device
for
the
deaf 
only

California
Relay
Service
(711)
 
 
www.jsco.net
 
Page
1
of 6
 
TEMPLATE Revised 07-08-2010 LS
DO NOT DUPLICATE
ONE APPLICATION PER HOUSEHOLD ONLY 
The Studios at Hotel Berry
729 L Street, Sacramento, CA 95814APPLICATION FOR ADMISSION
The Studios at Hotel Berry will comply with the provisions of any federal, state or local law prohibiting discrimination inhousing on the basis of race, color, creed, ancestry, national origin, sex, sexual orientation, familial status, source of income, age, disability, AIDS, or AIDS relation condition.TDD Telephone device for the deaf only - California Relay Service (711).
Please fill in all blanks. Incomplete applications will not be processed.APPLICANT NAME
:DATE OF BIRTH: SOCIAL SECURITY #:
CURRENT ADDRESS
: APT. #:CITY, STATE, ZIP CODE:
HOME PHONE #
: WORK #: OTHER WORK #:CELL PHONE #: OTHER#:FAX #:E-MAIL: ________________________________ INDICATE TWO PEOPLE WHO GENERALLY KNOW HOW TO CONTACT YOU:1. NAME: ______________________________________ 2. NAME: ____________________________________  ADDRESS: ___________________________________ ADDRESS: ___________________________________ PHONE #:____________________________________ PHONE #:____________________________________ DO YOU OWN A CAR? _______ 
PORTIONS OF THIS COMMUNITY ARE NON-SMOKING
 
Smoking is prohibited in the common area on floor one (1) and the studio units on floors two (2), three (3) and four (4).Smoking is allowed inside the studio units on floors five (5) and (6), but prohibited in common areas and hallways onthese floors. Are you a smoker? YES _______ NO ________ 
CURRENT HOUSING STATUS
How many people live in your home now?
 
www.jsco.net
 
Page
2
of 6
 
TEMPLATE Revised 07-08-2010 LS
Have you had your residency/tenancy terminated for fraud, non-payment of rent or failure to comply with leaseprovisions? ____ YES ____ NO. If 
YES
, please explainHave you been convicted of a felony? ____ YES ____ NO. If 
YES
, please list the disposition behind each incident:Do you have any family members or friends who currently work at this property?YES. _____ If 
YES
, name of employee: ___________________________________________ NO. _____ Do you have a section 8 voucher or certificate? Expiration Date:Yes No
Please list at least two (2) years of rental history below.
1.
CURRENT LANDLORD
:PHONE #: FAX #:WHAT IS YOUR CURRENT RENT? ____________ LANDLORD'S ADDRESS: ___________________________________________________________ DATE OF MOVE-IN:YOUR ADDRESS/APT. #:2.
PREVIOUS LANDLORD
:PHONE #: FAX #:RENT AMOUNT: $__________________ LANDLORD'S ADDRESS:DATE OF MOVE-IN: DATE OF MOVE-OUT:YOUR ADDRESS/APT. #:
INCOME INFORMATION
 Do you now receive or expect to receive income from any of the following sources?
For each 
YES
 answer, provide
the details in the chart below:
Income Monthly Gross Income
 Y
ES
N
O
 I am self-employed. (List nature of self employment) (use net income from business)$_________________ 
 Y
ES
N
O
 I have a job and receive wages, salary, overtime pay, commissions, fees, tips, bonuses,and/or other compensation: List the businesses and/or companies that pay you:Name of Employer 1)____________________________________________________________________ 2)____________________________________________________________________ $_________________ $_________________ 
 Y
ES
N
O
 I receive cash contributions of gifts including rent or utility payments, on an ongoingbasis from persons not living with me.$_________________ 

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