MELPET FARM APARTMENTS
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1 MELPET FARM APARTMENTS To all Lottery Applicants Housing Assistance Corporation and POAH Communities are the developers for the Melpet Farm Apartments. After many years of attempting to develop family rental housing on the Melpet Farm property, we are very happy to finally get to the point of offering applications for the lottery. Melpet Farm Apartments will contain 20 townhouse style, affordable apartments which will be available to residents at or below 60% of Barnstable County s area median income. These income levels are determined by household size and can be found within the Lottery Application Instructions. There will be six 1 bedroom (includes one accessible unit), eleven 2 bedroom and three 3 bedroom apartments. The site will contain 64 outdoor parking spaces (approximately 2/unit), on-site laundry, and community room and management office. Rents include heat and electricity. There are 7 units set aside for incomes they are at or below 30% of area median income. These units will be covered under a Project-based Section 8 contract. Applicants facing homelessness or at the risk of being homeless will be given priority and are strongly encouraged to apply. These seven units will not be included in the lottery and applicants interested in applying for these units need to contact POAH Communities at or to be placed on the wait list. This package includes the Lottery Application Instructions and the Lottery Application. Please follow the instructions and mail your application, along with required income documentation, early. No need to wait for the application deadline of Friday, June 12, 2015 at 5:00 PM, You are strongly encouraged to attend the Information Session on Wednesday, April 29, 2015, 5:30 PM at the West Dennis Graded School, 67 School Street, West Dennis where you will hear about the development, meet the HAC staff who will be working with you and learn about the lottery process. We look forward to meeting and working with you. 460 West Main St. Hyannis, MA hac@haconcapecod.org fax:
2 460 West Main Street Hyannis, MA T (508) F(508) TTY on all lines MELPET FARM APARTMENTS LOTTERY APPLICATION INSTRUCTIONS Application Process 1. You must fill out the Lottery Application completely and return it with the required documentation no later than Friday, June 12, 2015 at 5PM. Answer all questions. Only complete and signed Lottery Applications (with necessary documentation) will be included in the lottery. RETURN IN PERSON OR BY MAIL TO: RETURN BY FAX TO: HOUSING ASSISTANCE CORPORATION ATTN: BRIDGET ARMSTRONG 460 WEST MAIN STREET RETURN BY TO: HYANNIS, MA barmstrong@haconcapecod.org 2. Please submit copies of 5 consecutive most recent pay stubs and copies of 3 consecutive most recent bank statements (checking and savings) for all adult household members. These documents must be included with the Lottery Application. DO NOT SEND ORIGINALS. 3. Maximum gross household income for these units is as follows: INCOME QUALIFICATIONS MAX RENT LOW INCOME 60% GROSS INCOME UNIT SIZE 1 PERSON 2 PEOPLE 3 PEOPLE 4 PEOPLE 5 PEOPLE 6 PEOPLE 1 BR $877 $36,780 $42,000 2 BR $1,077 $42,000 $47,280 $52,500 3 BR $1,240 $47,280 $52,500 $56,700 $60, Minimum gross income (Income necessary to afford the rent) for apartment size is as follows: 1 BEDROOM $26,310 2 BEDROOM $32,310 3 BEDROOM $37, Household Size Definition A household shall mean an individual or 2 or more persons who will live in the apartment as their primary residence. Household size will be appropriate for the number of bedrooms in the apartment. 6. Information provided on this Lottery Application is confidential. 7. Applicants with a sensory or mobility disability may request an accessible unit, an extra bedroom for equipment or for a Personal Care Attendant, a reasonable modification of the housing or a reasonable accommodation of rules, policies, practices or services, necessary to afford the disabled person an equal opportunity to use and enjoy housing. 8. Your household can file only one application, and no household member can appear on more than one application. Incomplete applications missing any information or required documents will not be processed. MAKE COPIES OF PAY STUBS AND BANK STATEMENTS. ORIGINALS WILL NOT BE ACCEPTED. 9. Eligible applicants will be notified by mail of their lottery number. The notification letter will provide the date, time and location of the lottery. Attendance is not mandatory, but eligible applicants are encouraged to attend. No units will be awarded at that time. The Property Manager will contact households in order of their ranking on the list created from the drawing. 10. Ineligible applicants will be notified in writing stating the reason for being determined ineligible. 11. The application deadline is Friday, June 12, 2015 at 5PM. Applications can be mailed to Housing Assistance Corporation, 460 West Main St., Hyannis, MA 02601, faxed to or ed to barmstrong@haconcapecod.org. You are encouraged to attend the Information Session on Wednesday, A p r i l 29, 2015 at 5:30 PM. This will be held at the West Dennis Graded School, 67 School Street, West Dennis.
3 12. Applicants with gross household income of 30% or less (see table below) can request a Project Based Voucher Application from POAH Communities. When you submit the application to them your name may be placed on the wait list for the seven PBV apartments. You can contact them at POAH Communities, or Ph: , Fax: Household Size % Income limit $18,400 $21,000 $23,600 $26,250 $28,410 $32,570 Lottery Process 1. Lottery numbers for all eligible applicants are pulled at random from all pools for which they are eligible. 2. If the number of minority applicants in the local pool is less than the percentage of minorities in Barnstable County, a preliminary lottery comprised of all minority applicants who did not qualify for the local preference pool will be held and applicants will be added to the local pool in order of drawing until the percentage of minority applicants in the local preference pool is equal to the percentage of minorities in Barnstable County. 3. Every eligible applicant will be entered into the open pool. 4. Applicants who live, work or have children who attend school in the Town of Dennis will be entered in an additional local pool. Fourteen units have been set aside for local preference applicants. 5. Housing Assistance Corporation will send letters to each applicant with the results of the lottery. Tenant Selection Process 1. POAH Communities is the management agency and will receive a list showing the results of the lottery and all Lottery Applications to begin the Tenant Selection Process. When your name is pulled from this list, you will complete a Rental Application for POAH Communities that will include verification of information provided on the Lottery Application as well as other screening criteria defined in the Tenant Selection Plan. HAC does not discriminate in the selection of applicants on the basis of race, color, national origin, disability, age, ancestry, children, familial status, genetic information, marital status, public assistance recipiency, religion, sex, sexual orientation, gender identity, veteran/military status, or any other basis prohibited by law.
4 460 West Main Street Hyannis, MA T (508) F(508) TTY on all lines MELPET FARM APARTMENTS LOTTERY APPLICATION DEADLINE: Friday, June 12, 2015, 5PM Please see Lottery Application Instructions HOUSING ASSISTANCE CORPORATION WILL PROVIDE REASONABLE ACCOMMODATION AND/OR LANGUAGE ASSISTANCE IF NEEDED WHEN FILLING OUT THIS APPLICATION. PERSONS WITH DISABILITIES MAY ASK FOR THIS APPLICATION IN LARGE PRINT TYPE, OR OTHER ALTERNATE FORMATS. Assinale este quadrado se você lê ou fala português. Marque esta casilla si lee o habla español. Applicant s Name: SSN: Address City: State: Zip: Home #: Cell #: Work #: Co-Applicant s Name: SSN: Address (if different): _City: MA: Zip: Home #: Cell #: Work #: _ Household Information: List all members of your household and their relationship to the Head of Household. A household shall mean an individual or 2 or more persons who will live in the apartment as their primary residence. Household size will be appropriate for the number of bedrooms in the apartment. List All Household Members Relationship Student Status for members 18 and over Head of Household Last 4 digits of Social Security Number RENTAL ASSISTANCE Do you have a mobile Section 8 or MRVP voucher? YES NO SECURITY DEPOSIT: Please indicate how much money you have for a security deposit: $ CITIZENSHIP: Are you a U.S. Citizen? YES NO If no, do you have permanent resident alien status? YES NO 1
5 INCOME INFORMATION Income must be reported for all household members 18 and over. Total annual gross (before taxes) income includes all income from all sources such as employment, social security, child support, alimony, VA benefits, unemployment, etc. Assets are cash on hand, held in savings & checking accounts, and stocks, bonds, IRA s, 401K s, pension funds and real estate owned. You must submit 5 most recent consecutive pay stubs and 3 most recent consecutive checking and savings account statements with this application. ANNUAL INCOME Source Applicant Co-Applicant Other Household Members 18 & over Salary/Regular Pay Total Overtime Pay Commissions Fees Tips Bonuses Interest Dividends Net Income From Business Net Rental Income Periodic S S, Pensions, Retirement Funds, Etc. Unemployment Benefits Workers Compensation Alimony, Child Support TAFDC Part Time Work Other Total for each household member: TOTAL HOUSEHOLD INCOME: $ 2
6 ADAPTED FOR PEOPLE WITH DISABILITIES We will not discriminate in the selection of applicants on the basis of disability. If you or a member of your household need a unit with special design features, please check appropriate box: Mobility Vision Hearing LOCAL PREFERENCE Definition: You live in the Town of Dennis, or you are a municipal employee of the Town of Dennis, or you work in the Town of Dennis, or you have a child who attends school in the Town of Dennis. You are required to provide documentation of your local preference. (lease, utility bill, car registration, pay stub, letter from employer or school, etc.) Submit this documentation with your lottery application. I am a municipal employee for the Town of Dennis OR I work in the Town of Dennis OR I live in the Town of Dennis OR My child attends school in the Town of Dennis I DO NOT have a local preference CONFLICT OF INTEREST Does the applicant work at either POAH Communities or Housing Assistance Corporation or is the applicant related to someone at either of these organizations? (If yes please explain) Yes: No: APARTMENT SIZE Maximum household income for these apartments is as follows: TABLE 1 Household Size 1 Person 2 Person 3 Person 4 Person 5 Person 6 Person _ Maximum Income $36,780 $42,000 $47,280 $52,500 $56,700 $60,900 Minimum gross income (income necessary to afford the rent) for apartment size is as follows: TABLE 2 1 BEDROOM $26,310 2 BEDROOM $32,310 3 BEDROOM $37,200 Your gross annual income should be equal to or less than the maximum income for your household size (see TABLE 1) and equal to or more than the minimum income to afford the rent (see TABLE 2). If you have a mobile voucher, the minimum incomes do not apply to your household. Based on your household size and your household income, you will be entered into one or more of the lottery drawings as shown in TABLE 3. TABLE 3 Apartment Apartment Size 1-Bedroom Apartment (1-2 person households) 2-Bedroom Apartment (2-4 person households) 3-Bedroom Apartment (3-6 person households) 3
7 EQUAL OPPORTUNITY / FAIR HOUSING INFORMATION The following information will be required by the Federal Government to monitor this owner / management agent s compliance with Equal Housing Opportunity and Fair Housing Laws. The law provides that an applicant may not be discriminated against on the basis of the information supplied below whether or not the information is furnished. RACE OR NATIONAL ORIGIN (Your response to this section is voluntary.) White / Non-Minority Black or African American Asian ETHNICITY Hispanic/Latino Native Hawaiian or Pacific Islander Native American or Alaskan Native Please Read each item below carefully before you sign. 1. I/we hereby certify that the information provided in this Lottery Application is correct to the best of my knowledge. 2. I/we have attached 5 most recent consecutive pay stubs as stated in the application instructions for all household members 18 years of age or older. 3. I/we have attached the most recent 3 consecutive months of statement for all bank accounts of all household members. 4. I/we have attached a copy of documentation to verify my/our status for local preference. 5. I/we understand that if all the required documentation requested above is not submitted by the application deadline, we will not be eligible for the lottery. 6. I/we understand this is a Lottery Application and the information provided does not guarantee housing. Additional information and verifications will be necessary to complete the tenant selection process. 7. I/we understand that I may submit only one Lottery Application per household and that duplicate household applications will disqualify my household from the lottery. 8. I/we understand that the information submitted in this application for the lottery may be verified and that this application and documentation will be given to the property management company after the lottery. 9. Applications can be submitted as soon as they are complete but they must be received no later than Friday, June 12, 2015 at 5:00 PM. Applications can be mailed to Housing Assistance Corporation, 460 W. Main St., Hyannis, MA 02601, faxed to or ed to Bridget at barmstrong@haconcapecod.org. Your signature confirms that you have read the above statements. Applicant s Signature Last 4 digits of SSN Date Co-Applicant s Signature Last 4 digits of SSN Date HAC does not discriminate in the selection of applicants on the basis of race, color, national origin, disability, age, ancestry, children, familial status, genetic information, marital status, public assistance recipiency, religion, sex, sexual orientation, gender identity, veteran/military status, or any other basis prohibited by law. 4
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