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One Penn Plaza, Box 6121, New York, NY 10119
Dear Prospective Applicant: Thank you for requesting an application for an affordable apartment at West 39th Street Apartments located on West 39th Street, between Eighth and Ninth Avenues, in the Clinton section of Manhattan. Because this project is being constructed through the Inclusionary Housing Program of the New York City Department of Housing Preservation and Development (HPD) and is financed with federal Low Income Housing Tax Credits and tax-exempt bonds issued by New York State Homes and Community Renewal (HCR), forty-one (41) apartments are set-aside for low and very low-income households to be made available through a lottery. The following process will be used to select qualified tenants for this project. Soon after the application deadline of April 14, 2012, a lottery will be conducted. The applications will be opened, logged in and reviewed in numerical order. Ineligible applicants will be sent letters stating the reason for ineligibility. Credit reports will be run for applicants who preliminarily appear to be eligible and those with acceptable credit histories will be scheduled for interviews. The steps in determining final eligibility include: conducting office interviews; performing credit, landlord/tenant court and criminal checks; collecting all necessary documentation and verifications; and conducting visits to the applicant’s home. Upon a final determination of eligibility, applicants will be selected for apartments according to log number order and availability of the appropriate size apartment. Preference will be given to: Manhattan Community Board #4 residents for 21 units; mobility-impaired persons for two (2) units; visual and/or hearing-impaired persons for one (1) unit; and City of New York municipal employees for two (2) units. Additionally, preference for all units will be given to applicants who live in New York City. Applicants who submit more than one application will be disqualified. Photocopied applications will not be accepted. Additionally, only applications submitted by regular mail will be accepted. Applications postmarked after April 14, 2012 will be set aside for possible future consideration. An applicant’s eligibility will be based on the applicant’s circumstances at the time the applicant’s log number is called up, not circumstances which later change. Further, applicants must continue to qualify throughout processing. At any point in processing, until a lease and move-in affidavit are executed, if an applicant is determined to be ineligible, the application will be terminated. Applicants have the right to a written appeal, which must be submitted within fourteen (14) days of a termination. After all apartments have been rented, all remaining applicants will be sent letters indicating that they are on the waiting list. As low-income units become available, the owner will contact applicants who are on the waiting list, following the same procedures and criteria as during the initial rent-up. All applicants will receive correspondence from the owner at some point, either due to an ineligibility determination, scheduling of an interview, or placement on the waiting list. Depending on your lottery number, this correspondence should occur anywhere from approximately one month to one year after the application deadline. To qualify for the program, the household must meet all requirements established by law, regulation and the owner. The major reasons for an ineligibility determination are: household income either is under the minimum income or over the maximum income for the appropriate household and apartment size; there is no apartment available for the household’s size; the household is temporarily low-income, not demonstrating a long-term need for this affordable housing; and all adult members of the household do not sign the certification on the last page of the application. Some of the other factors that will be considered in determining eligibility are the applicant’s/household’s: student status; credit and payment history; length and stability of employment; consistency and authenticity of documentation; timeliness of appearing for interviews and providing documentation; housekeeping habits; and criminal record. The attached chart details the minimum and maximum incomes for specific household and apartment sizes, as well as the number of each apartment size available and corresponding rent. Prospective applicants should be aware that this is a governmentally assisted housing program. The submission of false or knowingly incomplete information at any point during the application process will result in an applicant’s disqualification, termination of a lease (if discovery is made after the fact), and referral to the appropriate authorities for further action, including potential criminal prosecution. All paperwork and documents submitted by applicants are subject to review by the New York City Department of Investigation, a fully empowered law enforcement agency of the City of New York. Now that you have an overview of the tenant selection process for an apartment in West 39th Street Apartments, please fill out the enclosed application carefully and completely, and mail it to the address listed on the application. Applications must be postmarked by April 14, 2012. We look forward to receiving your application. Sincerely, West 39th Street Apartments
West 39th Street Apartments WE HAVE RECEIVED YOUR INQUIRY REGARDING AN APARTMENT. including the New York City Department of Investigation.500 SET ASIDE FOR HOUSEHOLDS WITH INCOMES AT OR BELOW 40% OF MEDIAN FAMILY INCOME: # APTS AVAILABLE APARTMENT TYPE MONTHLY RENT HOUSEHOLD SIZE TOTAL GROSS ANNUAL INCOME RANGE Minimum .$23.Maximum 5 20 9 Studio 1 Bedroom 2 Bedroom $669 $720 $874 1 1 2 2 3 4 $24. e. SET ASIDE FOR HOUSEHOLDS WITH INCOMES AT OR BELOW 50% OF MEDIAN FAMILY INCOME: MAIL APPLICATION IN AN ENVELOPE TO: # APTS AVAILABLE APARTMENT TYPE MONTHLY RENT HOUSEHOLD SIZE TOTAL GROSS ANNUAL INCOME RANGE Minimum . criminal prosecution.920 .$23. NY 10108 IF ANY MEMBER OF THE APPLICANT HOUSEHOLD IS MOBILITY.200 $31. Rent Includes Gas for Cooking and Heating.325 .891 .350 $31.560 $25. VISUAL.$33.240 $21.050 $26. FILL OUT THE APPLICATION AND MAIL IT IN AN ENVELOPE.$26. APPLICANTS WHO SUBMIT MORE THAN ONE APPLICATION PER HOUSEHOLD WILL BE DISQUALIFIED.611 .200 $31.674 . Rents and Income Requirements Subject to Change.$33. PLACE A CHECK MARK () ON THE OUTSIDE OF THE ENVELOPE UNDER YOUR RETURN ADDRESS. visual and/or hearing impaired persons for 1 unit. Preference for all units will go to New York City residents.611 .200 Note: Apartment Type Subject to Occupancy Criteria. WEST 39th STREET APARTMENTS LOTTERY TIMES SQUARE STATION BOX 977 NEW YORK.$37. HOUSEHOLD SIZE AND ADDITIONAL SELECTION CRITERIA.$29. OR HEARING IMPAIRED. mobility-impaired persons for 2 units. ENCLOSED IS AN APPLICATION.988 . for further action. Note that submission of false or knowingly incomplete information will result in disqualification and referral to appropriate authorities.240 $21.g.$29.$26. 2012 TO BE INCLUDED IN THE LOTTERY.$29.611 . APPLICATIONS WILL BE ACCEPTED BY REGULAR MAIL ONLY! APPLICATIONS POSTMARKED AFTER APRIL 14. PHOTOCOPIED APPLICATIONS WILL NOT BE ACCEPTED.$33.Maximum 1 4 2 Studio 1 Bedroom 2 Bedroom $524 $564 $688 1 1 2 2 3 4 $19. .674 .$41.560 $25. APPLICANTS WILL BE REQUIRED TO MEET INCOME. Preference will be given to: Manhattan Community Board #4 residents for 21 units.988 .050 $26.325 .988 . 2012 WILL BE SET ASIDE FOR POSSIBLE FUTURE CONSIDERATION.880 $25. YOUR APPLICATION MUST BE POSTMARKED BY APRIL 14. and City of New York municipal employees for 2 units.
HOUSEHOLD COMPOSITION List ALL persons who will live in the apartment you are applying for. the New York City Housing Authority. # Apt. place the application in an envelope. 5. P. Otherwise. Also. the New York City Housing Development Corporation. Please answer all questions and write neatly. Street Street Apt. Your application must be postmarked by April 14. registered. or the New York City Health and Hospitals Corporation? Yes No If Yes. or approval regarding the housing development that is the subject of this application? Yes No NOTE: If you answered Yes to Question 1 above. visual or hearing impaired.West 39th Street Apartments INSTRUCTIONS 1. you will be required to submit a statement from your employer that your application does not create a conflict of interest.O. your application will be deemed ineligible. You may only be a household member on one (1) application. This application is to be completely filled out by the applicant. You will be disqualified if you submit more than one (1) application. 2012. If you answered Yes to Question 2 above. the New York City Economic Development Corporation. No payment or fee should be given to anyone in connection with the preparation or filing of this application for housing. NY 10108. when you will also be required to provide other documents to verify your income and eligibility. Student? Yes or No Name Relation to Head Sex Age Birth Occupation If Yes. If any member of the household is mobility. decision. have you personally had any role or involvement in any process. express or overnight mail) will not be accepted. certified. including yourself. SECTION A. F/T or P/T? of Household (M/F) Date Head ab 9265 . photocopied applications will not be accepted. # e-mail address: City City State State Zip Zip (work) (cell) Relationship: Daytime Phone: Number of persons living there? In apartment applying for: How many persons. 6. Mail completed application by regular mail only to: West 39th Street Apartments Lottery. and no broker’s fee should be given to receive an apartment. New York. Log #_______________ FREE APPLICATION--DO NOT PAY ANYONE FOR THIS APPLICATION Mail only one (1) original application per household. Include all persons for whom this unit will be a permanent residence/address. please identify the agency or entity at which you are employed: Agency/Entity 2) If you answered "yes" to Question 1 above. 2. GENERAL INFORMATION Applicant Name: Home Address: Mailing Address.g. Times Square Station. place a check mark () on the outside of the envelope under your return address. All adult members of the household must sign the certification on the last page of the application. Such statement would not be required until later in the application process. Box 977. notify: Address: In current unit: Number of bedrooms Briefly describe your reasons for moving: How did you hear about West 39th Street Apartments? (If newspaper. When completed. will live here? SECTION B. which one?) 1) Are you an employee of the City of New York. after you have been selected through the lottery. Applications not sent via regular mail (e. you may be required to submit a statement from your employer that your application does not create a conflict of interest. 4. priority. if different: Phone #: (home) In case of emergency. 3.
including Month/Year) Status F=Full-Time P=Part-Time S=SelfEmployed Household Member Name Name & Address of Employer Gross Annual Earnings $ $ $ $ $ Total Gross Annual Employment Income = $ OTHER INCOME Include gross periodic payments from: public assistance (including housing allowance). veteran’s. alimony. TANF. (Self-employment/business income. all persons who will live in the apartment you are applying for. child support. Line 12. part-time and self-employment income.Do you anticipate any additions to the household in the next twelve (12) months? Yes If yes. if applicable. annuities. SSI. Quarterly Annual Gross Amount $ $ $ $ $ $ $ Total Gross Annual “Other” Income = TOTAL GROSS ANNUAL INCOME: (Employment PLUS “Other” Income) Do you or any household member anticipate any changes in income in the next twelve (12) months? If yes. explain: Yes No . must reflect the amount that would be reported on IRS Form 1040. INCOME List below ALL current sources of income for ALL HOUSEHOLD MEMBERS. net rental income and other income from assets listed in Section D. “Assets. Bi-weekly. and Schedule C.” Period Received Household Member Name Source of Income $ $ $ $ $ Gross Amount per per per per per Weekly. Also. insurance policies. indicate who (name and relationship) Explain: Check if you or any member of your household has a disability: Mobility Visual No Hearing Describe any special accommodation needed if you or any member of your household is disabled: Will ALL of the household members (both adults and children) be full-time students during five (5) months or more of 2012 or will they all be full-time students during five (5) or more months of 2013? Yes No If yes.” i. EMPLOYMENT INCOME Include all full-time. Monthly.) Dates of Employment (From/To. AFDC. unemployment. Net Profit.. Semimonthly. pensions. listed in Section B. include interest. dividends. “Household Composition. disability. indicate the name(s) of the household member(s) and of the school(s) they are or will be attending: SECTION C. social security.e. including yourself. retirement funds. Line 31. and other regular income. Business Income.
bonds. including the home you live in? Yes No If Yes. jewelry.” (Income from these assets must be listed in “Other Income” in Section C. certificates of deposit. checking accounts. such as inheritance. trust funds. ASSETS List below the current cash value of all assets held by ALL household members. savings bonds. mutual funds.g. listed in Section B. do the terms of the account permit you to withdraw funds from the account now? Yes Yes No No Have you or any household member received any lump sum payments. IRA accounts. including yourself. insurance? Yes No If yes. life insurance policies (except Term). Household Member Name Institution Name Type of Asset Account # Current $ Value/ Account Balance TOTAL VALUE OF ASSETS = Do you or any household member have a pension or retirement account other than an IRA or Keogh? If yes. “Income”). antiques or art). describe why: Do you or any household member own any property. describe the asset Date of disposition: Amount disposed $ . other retirement and pension accounts. personal property held as an investment (e. stocks. gambling winnings. Include below: cash on hand. net annual rental income (amount that would be reported on IRS Schedule E. 401K accounts. “Household Composition. when? ______________________________ How much? _________________________________ Are these funds reflected in your asset list above? Yes No If not. Line 26): $ Have you or any household member sold/disposed of any property in the last twenty-four (24) months? If Yes. equity in real estate and all other assets. type of property: Date of transaction Market value when sold/disposed $ Amount sold/disposed for $ Yes No Have you or any household member disposed of or given away any other assets in the last twenty-four (24) months? (Examples: Given away money to relatives or set up Irrevocable Trust Accounts)? Yes No If yes. savings accounts. money market funds.SECTION D. type of property Location of property Appraised market value $ Mortgage or outstanding loans principal balance due $ If rental property.
starting with your most current employment. list in order all previous employment for the past two (2) years. (Signature) (Signature) (Date) (Date) (Signature) (Signature) (Date) (Date) . type? If yes to any questions above. MUST SIGN. I/We declare that statements contained in this application are true and complete to the best of my/our knowledge. I/We understand that eligibility for housing will be based on applicable income limits and management s selection criteria. S=Self-Employed Status RESIDENCE HISTORY (FIVE YEARS) Starting with your current address. a fully empowered law enforcement agency which investigates potential fraud in City-sponsored programs. not Hispanic/Latino CERTIFICATION Native Hawaiian/Other Pacific Islander I/We certify that this will be my/our primary residence. explain The following information is used only for statistical purposes and is optional: PLEASE CHECK THE RACE WHICH BEST DESCRIBES THE HEAD OF HOUSEHOLD: Black/African American American Indian/Alaska Native Asian White IS THE HEAD OF HOUSEHOLD OF HISPANIC/LATINO ORIGIN? Yes. 18 OR OLDER. SIGNATURE(S): ALL ADULT APPLICANTS. Address Dates (From/To) Name. P=PartTime. I/We have not withheld. Address and Phone # of Landlord Current monthly rent or mortgage payment amount: $ Your contribution: $ Check utilities paid by you: Heat Electricity Gas Other (specify) Are you presently receiving transferable rent subsidy? Yes No.SECTION E. and referral to the appropriate authorities for potential criminal prosecution. I/We understand that the consequences for providing false or knowingly incomplete information in an attempt to qualify for this program may include the disqualification of my/our application. Hispanic/Latino No. Household Member Name Name & Address of Employer Dates of Employment (From/To. If yes. list in order all addresses where you have lived for the past five (5) years. which? Section 8 Other (specify) _______________ Are you or any member of the applicant household currently using an illegal substance? Yes No Have you or any member of the applicant household ever been convicted of a felony? Yes No If Yes. I/We fully understand that any and all information I/we provide during this application process is subject to review by the New York City Department of Investigation (DOI). when? Have you or any member of the applicant household ever been evicted from housing? Yes No If Yes. when? Do you or any member of the applicant household have any pets? Yes No If Yes. the termination of my lease (if discovery is made after the fact). including Month/Year) F= Full-Time. falsified or otherwise misrepresented any information. ADDITIONAL INFORMATION EMPLOYMENT HISTORY (TWO YEARS) For any adult household member who has not been with their current employer for at least two (2) years or who is not employed currently. when? Have you or any member of the applicant household ever filed for bankruptcy? Yes No If Yes.
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