George s Mews Apartments Washington Street, Raleigh, NC (919)

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1 George s Mews Apartments Washington Street, Raleigh, NC (919) Thank you for your interest in George s Mews Apartments. We are now accepting applications for our one bedroom apartments. Enclosed you will find a current rental application. Each person over the age of 18 must complete and sign a separate Workforce Rental application. If a question does not apply to your household, please answer N/A (DO NOT LEAVE ANYTHING BLANK). We also ask that you use a pen when completing the application. As of June 2016, the minimum and maximum income requirements are as follows: Household Size Minimum Income Maximum Income Rent 1 $20,100 $21,480 $ $20,100 $24,520 $ (40% of AMI) 1 $26,010 $32,220 $ $26,010 $36,780 $ (60% of AMI) *Maximum income limits as of June 1, Subject to change according to HUD s AMI Requirements for submitting an application: 1. Completed Workforce housing application 2. Legible copy of a state issued identification 3. Legible copy of social security card (all persons over the age of 6) 4. Income and asset verifications 5. $100 Holding Fee (Money Order only) 6. Upon Approval, the following applies Utilities Tenant will be responsible for electric and water (Gas for selected units) Security deposit equal to one month s total rent Return the above information to CASA by at casahousing@casanc.org or: Physical Address Mailing Address 624 W. Jones Street P.O. Box Raleigh, NC Raleigh, NC Application Screening Process: CASA uses a third party screening company to verify the applicants background such as criminal, rental, credit and sex offender. Each person over the age of 18 must complete a separate application. The following screening process will apply: 1. Income Qualifications Show proof of verifiable income Pay check stubs: 6 consecutive pay stubs (within past 30 to 60 days of application date) Employment Offer letter Other forms of income can be used if properly documented. Ex: SSI/SSDI, a current awards letter from Social Security Administration. 2. Occupancy Standards - Two persons per bedroom 3. Rental History - Satisfactory rental history for the past two years. All unpaid debt to previous landlords must be satisfied prior to approval. 4. Criminal Background report past and present CASA has a No Pet Policy Rev. June 1, 2016

2 All applicants are required to be preapproved prior to accepting a housing application. The following information must be attached in order to be preapproved: Completed housing application Income verification (see cover sheet) Copy of Social Security Card Copy of state issued identification Office Use Only Property Applying For Vesson Court SB Village W. Geer Street George s Mews Abbey Court Dillard Street Johnson Street Cedar Street Unit Number: Holding Fee $100: (money order #) Monthly Rent: Deposit: (minus $100 Holding Fee) Move In Date Applicant s Information Full Name SS# Date of Birth Current phone number Cell Phone Driver s License or State Identification Number State No List others who will reside in the home on a permanent basis: Please provide a copy of each person (6 years of age and over) social security card. Name Date of Birth Relationship Full Time Student 1 No 2 No 3 No 4 No Residential (Past 2 Years) and Employment History Current Address Street Address Apt # City State Zip Month and Year moved in Rent $ Month and Year moved out Current Landlord/Agent Phone Number Reason for moving out Previous Address Street Address Apt # City State Zip Month and Year moved in Rent $ Month and Year moved out Previous Landlord/Agent Phone Number Reason for moving out Employer Name of Supervisor Salary $ per (month, hourly, annual) Begin Date Phone Number If current employment is less than 12 months, please provide the following information: Previous Employer Employment Dates (start and end dates) Contact Name Phone Number Salary $ Per (month, hourly annual)

3 Sources of Income Each person 18 and older should complete a separate application Type of Income Check One Wages, Salary, Employment, Etc. Yes No Income from a business or profession Yes No Military pay including all allowances Yes No Social Security Yes No SSI Yes No TANF or other Public Assistance Yes No Alimony Yes No Child Support Yes No Unemployment Compensation Yes No Workers Compensation Yes No Severance Pay Yes No Retirement Income Yes No Pensions Yes No Annuity Income Yes No Insurance policy income Yes No Disability or Death Benefits Yes No Income from rental property Yes No Regularly recurring gifts Yes No Scholarships Yes No Grants Yes No Educational Entitlements Yes No Work Study Programs Yes No Long Term Care payments Yes No Income from training programs Yes No Total Annual Income Comments List other income: If answered yes to any of the above questions, please provide a current print out of six (6) consecutive statements. Use the bottom of this page to list additional sources of income.

4 Each person 18 and older should complete a separate application Type of Asset Check One Checking Account(s) Yes No Savings Account(s) Yes No Certificates of Deposit* Yes No Money Market Funds Yes No Mutual Funds/Stock* Yes No Treasury Bills Yes No IRA or 401K Yes No Company Retirement Accounts* Yes No Annuity Income Yes No Life Insurance Policies (Whole Life)* Yes No Pension Funds* Yes No Trust Accounts Yes No Personal Property held for Investment Yes No Mortgage or Deed of Trust Yes No Cash held in Safety Deposit Boxes, etc. Yes No House/Real Estate* Yes No Rental Property Yes No Other Investments Yes No Total Annual Income Have you received any lump sum payments such as the following: Inheritances Yes No Lottery or other winnings Yes No Insurance Settlements Yes No Worker s Compensation Settlements Yes No Social Security Disability Settlements Yes No VA Disability Settlements Yes No Severance Pay Yes No Capital Gains Yes No Comments List other assets: If answered yes to any of the above questions, please provide a current print out of six (6) consecutive statements. Have you disposed of any assets for less than Fair Market Value within the last two years? (State if the sale was due to foreclosure, bankruptcy or divorce). Yes No If yes explain: *When listing the cash value of any of the items that have an asterisk, please keep in mind penalties for withdrawal, or any fees deducted to convert the asset to cash. For example, if you owned a home, and sold it, how much cash would you have after you paid off the mortgage, the realtor, etc.? That s the amount you should list in the value column.

5 General Information Automobile Information Model Make Tag Color Model Make Tag Color In case of emergency, illness or accident, please notify: Name Phone Relationship Name Phone Relationship Any unanswered yes or no shall result in the denial of your application 1. Do you have any special housing needs or request a Reasonable Accommodation or Modifications? Yes No 2. Have you ever been served an eviction notice? Yes No 3. Have you ever received an ordinance violation from the City of Raleigh? Yes No 4. Have you or any member of your household ever been: Yes No Convicted of or pled guilty or no contest to any felony? Yes No Convicted of or pled guilty or no contest to a sexual offense? Yes No Listed on a registry of sexual offenders? Yes No Convicted of or pled guilty or no contest to any drug related criminal offense? Yes No If yes to any of the above questions, please explain, providing the location, date and nature of the offense: Agreement & Authorization Signature I agree that all information listed on this housing application is true and correct. I also understand that falsifying information on this application can and will lead to a denied application or termination of a lease agreement. I also understand that in order to hold the unit identified on page one of this application, CASA shall retain the $ holding fee accompanying this application. Upon approval of this application and execution of a twelve-month lease, I understand that the holding fee will be applied against the security deposit. If this application is rejected for any reason other than the falsification of information by applicant, the holding fee shall be refunded to the applicant. If this application is not rejected and the undersigned fails to execute a twelve-month lease and occupy the unit identified on page one of this application by the move in date, CASA shall be entitled to retain the holding fee to cover CASA s various costs of holding such unit off the market. Applicant s Signature Date CASA has a No Pet Policy

6 Authorization to Release Information I, have applied for rental housing with CASA. I authorize CASA to perform a background check from the following: Online Rental Exchange Previous and current landlords Previous and current employers State CCBI and Records Department Income Verification including employment Verification Asset Verificationss Student Verification Alimony/Child Support Verification By signing below, I understand that the information provided by the agencies and individuals listed above will help decide the final approval of my housing application. I also understand that if I fail to sign this form, my housing application will be denied. Applicant s signature Date