THIS APPLICATION MUST BE FILLED OUT COMPLETELY. ALL AREAS THAT REQUIRE A SIGNATURE, MUST BE SIGNED AND DATED.

BROOKSIDE TERRACE APARTMENTS 33 MILL STREET

NEWTON, NEW JERSEY 07860

OFFICE 973-383-6080 FAX: 973-383-3635

KAREAMEH ABDELJABBAR HELEN ROBINSON

SITE MANAGER ASSISTANT MANAGER

THIS APPLICATION MUST BE FILLED OUT

COMPLETELY.

ALL AREAS THAT REQUIRE A SIGNATURE,

MUST BE SIGNED AND DATED.

ANY APPLICATION THAT IS INCOMPLETE,

WILL NOT BE PLACED ON THE WAITING

LIST, IT WILL BE RETURNED TO THE HEAD

OF HOUSEHOLD.

PLEASE PRINT CLEARLY. IF YOUR PHONE

NUMBER OR ADDRESS CHANGE BEFORE

YOUR NAME IS CALLED, CALL 973-383-6080,

MONDAY – FRIDAY BETWEEN 8:30 A.M. TO

4:30 P.M.,TO UPDATE YOUR INFORMATION

BROOKSIDE TERRACE

APARTMENT APPLICATION

PRINT ALL INFORMATION DATE___________________________ PROJECT:Brookside Terrace

33 Mill Street Newton, New Jersey 07860

A. APPLICANT Tel: 973-383-6080Fax: 973-383-3635

NAME____________________________________________________

ADDRESS __________________________________________________APT.__________________ CITY, STATE, ZIP CODE ____________________________________________________________ HOME PHONE # ___________________ WORK PHONE #_______________________CURRENT RENT $_________________

DO YOU PAY THE UTILITIES?_________HOW MUCH PER MONTH AVERAGE $ __________ (EXCLUDE PHONE)

LIST THE NAMES, ADDRESSES AND PHONE NUMBERS OF RELATIVES OR FRIEND WHO GENERALLY KNOW HOW TO REACH YOU.

1. NAME________________________________ ADDRESS:_______________________________ _______________________________________________________________________________ PHONE #: _______________________________

2. NAME ______________________________ ADDRESS: ______________________________ _______________________________________________________________________________

PHONE # _______________________________ B. HOUSING STATUS

HOW MANY PEOPLE RESIDE IN YOUR HOME?________HOW MANY BEDROOMS IN YOUR HOME?____________ WHY DO YOU WISH TO MOVE?__________________________________ __________________________________________________________________________________ ARE YOU BEING EVICTED?_____________(Yes or No) WHEN MUST YOU BE OUT OF YOUR HOME?____________

HAVE EVER BEEN EVICTED AND IF SO FROM WHERE AND WHEN?____________________ __________________________________________________________________________________ ARE YOU NOW IN A GOVERNMENT SUBSIDIZED RENTAL UNIT?_______ HAVE YOU EVER APPLIED_____________FOR A GOVERNMENT SUBSIDIZED UNIT BEFORE?_________IF SO, WHERE___________________________________________________________________________ HOW LONG HAVE YOU RESIDED AT YOUR CURRENT RESIDENCE?____________________ PRESENT LANDLORD’S NAME AND ADDRESS________________________________________ _________________________________________________PHONE # _________________________ FORMER LANDLORD’S NAME AND ADDRESS________________________________________ _________________________________________________PHONE # _________________________ C. FAMILY OR HOUSEHOLD COMPOSITION

LIST HEAD OF HOUSEHOLD, ALL OTHER HOUSE MEMBERS AND THEIR

RELATIONSHIP TO THE HEAD. ONLY LIST PEOPLE MOVING TO BROOKSIDE UNIT. MEMBER'S FULL NAME RELATIONSHIP BIRTH DATE AGE SOCIAL SECURITY

Do you have a SECTION 8 Voucher,(circle one)---Yes or No.

Do you have TRA (Temporary Rental Assistance?) (Circle one) Yes or No Are you on the waiting list for Section 8 (circle one)---Yes or No.

D. CHECK ONE (1) OF THE FOLLOWING: ________White (Non-Hispanic) _______Black (Non-Hispanic) ________Asian or Pacific Islander _______American Indian

________Hispanic _______Other

E. SOURCE OF INCOME

LIST ALL INCOME SOURCES. THIS INCLUDES, BUT IS NOT LIMITED TO, FULL AND/ PART-TIME EMPLOYMENT, ALL INCOME FROM WELFARE AGENCIES, SOCIAL

SECURITY, PENSION, SSI, DISABILITY, ARMED FORCES RESERVES, UNEMPLOYMENT COMPENSATION, CHILD CARE, ALIMONY, CHILD SUPPORT, SCHOLARSHIPS AND GRANTS, CONTRACT FOR DEED, INTEREST ON ASSETS, DIVIDENDS, ANNUITIES, REGULAR CONTRIBUTIONS FROM PEOPLE NOT RESIDING WITH YOU.

MEMBER EMPLOYEE, AGENCY, BANK, ETC. WHO ARE SOURCES OF ANNUAL GROSS NUMBER INCOME TO YOU. LIST NAME AND ADDRESS OF SOURCES. INCOME TO YOU

F. SOURCE OF INCOME

DO YOU OWN A CAR? YES_______NO________MAKE ______MODEL______YEAR_______ AUTOMOBILE LICENSE NUMBER______________DRIVERS LICENSE NUMBER__________ CHECKING ACCOUNT #________________BANK NAME _______________CITY___________ BALANCE______________

SAVINGS ACCOUNT #__________________BANK NAME _______________CITY__________ BALANCE______________

DO YOU OWN ANY TYPES OF BONDS? NOTE FACE VALUE TOTAL $_______________ STOCKS $______________ IF YOU OWN A HOME LIST THE ANTICIPATED GROSS SALE PRICE $________________

G. UNUSUAL AND MEDICAL EXPENSES

DO YOU PAY FOR CHILD CARE DUE TO EMPLOYMENT?_____WEEKLY COSTS $_______

IS CHILD CARE COST COVERED BY AFDC?________

DO YOU HAVE MEDICARE?_____DO YOU HAVE OTHER MEDICAL INSURANCE?_______

GIVE THE NAME OF THE INSURANCE COMPANY AND YOUR POLICY #________

WHAT IS YOUR DISABILITY OR ILLNESS?__________________________________________ DOES MEDICAID PAY YOUR DOCTOR AND DRUG BILLS_________ARE YOU RECEIVING MEDICAL ASSISTANCE THROUGH WELFARE?______IF YOU PAY ANY PORTION OF THE MEDICAL/DRUG COSTS, YOU SHOULD SUPPLY US WITH THE BILLS AND THE

H. DISPLACEMENT STATUS

ARE YOU BEING DISPLACED?___BY GOVERNMENT ACTION OR PRIVATE ACTION?____ LIST REASON____________________________________________________________________

PROGRAM INFORMATION

ARE YOU A VETERAN?______YEARS OF SERVICE (DATES)___________________ IF YOU ARE HANDICAPPED LIST THE EXTENT OF YOUR DISABILITY

______________________________

I AGREE TO GIVE THE OWNER/AGENT THE AUTHORITY TO CONDUCT A CRIMINAL BACKROUND CHECK, SEX OFFENDER SEARCH, TO INVESTIGATE MY CREDIT RATING AND MY CURRENT AND PAST RENTAL HISTORY. THE INFORMATION OBTAINED WILL BE USED FOR MANAGEMENT PURPOSES ONLY AND WILL BE HELD IN

CONFIDENCE. I HEREEBY ACKNOWLEDGE THAT ALL APPLICATION INFORMATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE:

____________________________________ _________________________________

SIGNATURE DATE

NOTE: The following questions pertain to yourself and every member of your household who will occupy the unit during the period in which you will receive Assistance.

YES NO A. EMPLOYMENT

( ) ( ) 1. Is any member of your household employed, either full-time, part-time or seasonally?

( ) ( ) 2. Did any member of your household expect to work for any period of time during the coming months?

( ) ( ) 3. Does any member of your household expect to work for any period of time during the coming months?

( ) ( ) 4. Is any member of your household on a leave of absence from work due to lay-off or for reasons of medical military, or maternity leave?

( ) ( ) 5. Is any member of your household on probationary status at work?

( ) ( ) 6. Does any member of your household expect to be rehired by their past employer?

( ) ( ) 7. Does any member of your household expect to be terminated from work in the near future?

( ) ( ) 8. Has any member of your household waiting to be called by a prospective employer?

( ) ( ) 9. Is any of your household waiting to be called by a prospective employer?

( ) ( ) 10. Does any member of your household work for a person who pays them in cash?

YES NO B. UNEMPLOYMENT BENEFITS

( ) ( ) 1. Is any member of your household receiving or expecting to receive unemployment benefits?

C. BENEFITS

( ) ( ) 1. Does any member of your household receive or expect to receive child support?

( ) ( ) 2. Has any member of your household ever applied for child

support?

( ) ( ) 3. Has any member of your family pay you money

on a regular basis?

( ) ( ) 4. Does any member of your household receive or expect to receive welfare?

( ) ( ) 5. Has any member of your household ever applied for welfare?

( ) ( ) 6. Is any member of your household receiving or expecting to receive Social Security?

( ) ( ) 7. Has any member of your household applied for Social Security?

( ) ( ) 8. Does any member of your family receive any additional money?

( ) ( ) 9. Is any member of your household receiving financial aid or work-study?

D. OTHER

( ) ( ) 1. Is anyone in your household a member of the Armed Forces or Reserves?

( ) ( ) 2. Is any member of your household in the process of enlisting?

( ) ( ) 3. Is there anyone not listed on your application living in your unit or spending any time at your unit?

( ) ( ) 4. Do you expect any one to do so in the future?

_________________________________ ___________________________ APPLICANT SIGNATURE

To Applicant:

Please note that periodically the Rental Office will be sending letters to update the waiting list. YOU MUST RESPOND IN WRITING TO THE MANAGEMENT OFFICE INDICATING WHETHER OR NOT YOU WANT TO REMAIN ON THE WAITING LIST. IF WE DO NOT HEAR FROM YOU IN THE TIME SPECIFIED, YOUR

APPLICATION WILL BE REMOVED FROM THE WAITING LIST.

Also, at any time there is a change of address or phone number, it is your responsibility to notify our office. If we are unable to contact you because of an incorrect address or phone number, your application will be removed from the waiting list.

I. INVOLUNTARLY DISPLACED(or expected to be displaced within six months) A. Reason for Displacement (describe circumstances on the appropriate line)

1. Disaster:____________________________________________ ___________________________________________________

2. Government Action:___________________________________ ___________________________________________________ 3. Action by Owner:_____________________________________ ___________________________________________________ 4. Are you or any other member of your household a victim of domestic violence?____________________________________

5. Other:______________________________________________ ___________________________________________________

B. If you are already displaced, what are your current living arrangements? ________________________________________________________ C. If you are not already displaced, when do you expect to be displaced? ________________________________________________________ II. LIVING IN SUBSTANDARD HOUSING

A. Building is dilapidated (describe)_____________________________ _______________________________________________________

B. Inoperable plumbing___________ C. Unusable flush toilet___________

D. Unusable bathtub or shower____________ E. No electricity or unsafe service__________ F. No safe or adequate source of heat ___________

G. Should, but has no kitchen facilities__________

H. Has been declared unfit for habitation (explain)______________________________ ________________________________________________________________ I. Applicant is homeless (describe current living conditions)_____________________ ____________________________________________________________________

III. APPLICANT IS PAYING MORE THAN 50% OF INCOME FOR RENT

What is your gross monthly income?__________________________________________ What is your monthly rent?__________________________________________________ What are your monthly utility costs paid for directly by you?

Rent + Utility Costs divided by Gross Monthly

Income equals: ___________ Percent

The Landlord agrees not to discriminate based upon race, color, religion, creed, national origin, sex, age, familial status, and disability.

Brookside Terrace does not discriminate on the basis of handicapped status in the admission or access to, or treatment or employment in, its federally assisted programs and activities.

I understand that each eligible applicant with or without a Federal preference must meet the owner’s tenant selection criteria before gaining acceptance for tenancy.

Signature of Applicant_________________________________Date_______________________ Signature of Spouse, _________________________________Date_______________________ Co-head or Occupant

Brookside Terrace

33 Mill Street Newton, NJ 07860

973-383-6080 973-383-3635 Fax

I,_____________________________________

PRINT NAME

HAVE RECEIVED AND READ THE TENANT

SELECTION POLICY.

KEEP THE TENANT SELECTION POLICY FOR

YOUR RECORDS.

SIGNATURE______________________________

DATE_____________________

THIS PAGE MUST BE RETURNED WITH THE

APPLICATION.

KEEP FOR YOUR RECORDS

BROOKSIDE TERRACE TENANT SELECTION POLICY

Brookside Terrace has formulated a Tenant Selection Policy, which meets HMFA requirements. This Policy establishes a set plan, which can be consistently applied to all applicants.

ELIGIBILITY CRITERIA

Prior to being placed on the waiting list and again during processing for occupancy, an applicant must qualify under ALL eligibility criteria. These criteria are as follows:

I. Income limits are established and adjusted annually. The household’s annual

income may not exceed the applicable income limits for this property or for the household size.

II. Rent. The applicant must agree to pay the rental amount established. In

addition, if an applicant has TRA, DCA or SHE, they must be capable of paying the rent amount established for a minimum of 36 months and notify the

management office at least 6 months before your temporary assistance expires so you can be placed on Brookside’s list for assistance. Brookside Terrace cannot guarantee you assistance if and when your temporary assistance expires. We can only extend a subsidy to qualified applicants and/ or tenants when we have subsidies available. Third party personal checks will not be accepted. III. Only Residence. The unit must be the household’s only residence.

Assistance may not be provided to households who maintain another residence in addition to the assisted unit.

IV. Household. Only those individuals listed on the lease may reside in the unit. V. Unit size requirements. The applicant must abide by the following unit size requirements:

A. No more than two persons will be allowed per bedroom.

B. In order to maximize the use of available housing, management will strive for occupancy of two persons per bedroom. Valid exception to this policy:

1. State or local occupancy laws, which restrict the number of persons. 2. Husband and wife or co-tenants who cannot sleep together for medical

reasons of which a doctor’s statement is required.

3. A handicapped or elderly adult requiring live-in assistance. However, the final decision is at the discretion of the tenant. 4. Two children of the same sex who cannot occupy the same room for medical reasons; which a doctor’s statement is required.

5. Management will encourage parents with children of the opposite Sex to have the children occupy separate bedrooms.

However, the final decision is at the discretion of the tenant. 6. Management will encourage adults not to share the same bedroom

with a child. However, the final decision is at the discretion of the tenant.

7. Compliance with applicable HUD regulations regarding assignment of a larger unit.

VI. Social Security Numbers. The applicant must disclose the Social Security Numbers of all household members. If a household member does not have a Social Security Number, the applicant must sign a certification to that fact. VII. Restrictions on Assistance to Non-Citizens. Assistance can only be provided for applicants and their household members if they are either United States Citizens, Nationals or have eligible immigration status.

1. Applicants and all household members claiming to be a U.S. Citizen or

A National must sign a declaration attesting to such status. When the household member is a minor child, the declaration must be signed by

the parent or a responsible adult.

2. Applicants and all household members claiming to have eligible Immigration status AND who are 62 years of age or older, must sign a declaration attesting to such status AND provide proof of age.

3. All other applicants and household members claiming to have eligible immigration status must sign a declaration attesting to such status AND provide INS documents supporting said status. When the household member is a minor child; the declaration must be signed by the parent or a responsible adult. ALL information provided in support of eligible immigration status must be independently verified with the INS before eligibility can be determined.

a) Assistance can only be provided for the household members whose eligible immigration status has been provided.

b) Should the household contain eligible and ineligible household members, assistance will be provided in accordance with HUD regulations.

An elderly family is defined as a family whose head, spouse or sole member are persons at least 62 years old.

Students applying to be either head-of household or co-head must meet the following eligibility requirements:

* Must have maintained a separate household from parents or guardians for at least a year before applying to the community or

• Is an orphan or ward of the court and are 18 years old or younger • Is a veteran of the U.S. Armed Forces

• Has a legal dependent other than a spouse; such as a child or elderly parent • Is a professional or graduate student

• Is married

• Is at least 24 years old or will turn 24 years old this year.

* Was not claimed as a dependent on your parents or legal guardians most recent tax returns.

VIOLENCE AGAINST WOMEN ACT 2005

• An application can’t be rejected solely because the applicant is a victim of domestic violence, or has been previously evicted from another assisted site for being a victim, as long as s/he meets all project eligibility requirements.

• The Violence Against Women Act and the Justice Department Reauthorization Act of 2005 protect tenants and family members who are domestic violence victims, which include dating violence and stalking, from subsidy termination and eviction for acts of violence against them.

• A victim will be required to certify domestic violence incidents and must include the name of the abuser and the abuser’s relationship to the victim. Third party verification from a victim service provider, a medical professional or an attorney will be required. These victims will not be evicted based on domestic violence incidents.

• Domestic violence victims may be evicted for lease violations that are unrelated to domestic violence disturbances. Victims may be evicted if it can be shown that the victim’s residency poses an actual and imminent threat to other tenants, or to site staff.

• A domestic abuser will be evicted and their name removed from the lease. Remaining household members may continue to stay in the unit as long as they are eligible.

MARKETING

Advertising that applications are being accepted for available units will be in accordance with the Affirmative Fair Housing Marketing Plan when said Plan is required.

1. Application.

A) A written application must be completed by all applicants. An applicant may pick up an application at the rental office or request that an

application is mailed to them. No application will be issued if the waiting list is closed.

B) As completed applications are received in the rental office, they are dated, stamped, numbered consecutively and placed on the waiting list. All applicants are processed to one of the three requirements: applicants are admitted to a unit, applicants are rejected because they do not meet all eligibility criteria; applicants remain on the waiting list until an appropriate sized unit becomes available. NOTE: Being placed on the waiting list does not guarantee occupancy of a unit. The applicant can be subsequently rejected for failing one or more of the tenant screening criteria, and/or the eligibility criteria.

WAITING LIST

Applicants will be placed on the waiting list in chronological order. Applicants placed on the waiting list will be notified, in writing, that they will be contacted when an appropriate sized unit becomes available and approximately how long it will take for a unit to become available.

Applicants on the waiting list are required to report, in writing, to the rental office any change of address, telephone numbers or other information that may affect eligibility. If an applicant cannot be reached by the rental office due to unreported changes, the applicant will be removed from the waiting list.

Applicants will be offered one unit, appropriately sized to suit the family composition. If the family does not choose to move into the unit, but wishes to remain on the waiting list, their name and application will be placed at the

bottom of the waiting list. Brookside Terrace will offer a maximum of three units following this procedure. If, at the third offering, the applicant chooses

not to move into Brookside Terrace, their name and application will be removed permanently from the waiting list.

TENANT SCREENING AND REJECTION CRITERIA

The tenant screening and rejection criteria always applies to all individuals listed as head of household, spouse, co-head of household and members 18 years of age or older, who are expected or proposed to reside in the unit.

An applicant household and/or any additional household member who is proposed to reside in the unit, will be refused occupancy for one or more of the following reasons:

A) If an applicant fails to meet one or more of the eligibility criteria

B) If the applicant submits false information about themselves or any household member.

C) If the applicant is unable to produce and/or verify the social security numbers of all household members. If a household member does not have a social security number, the applicant must sign certification to that fact.

D) Poor credit history.

1) Applicants will sign a release for us to obtain a credit report from a reputable credit reporting agency.

2) Applicants with poor credit history will be rejected. E) Landlord Verification

1) Applicants must demonstrate good rent paying habits

with no more than two payments per year being made after a grace period and no legal actions begun for non-payment of rent.

2) For applicants with no prior rental history, evidence of meeting other financial obligations will be considered.

3) A written third party verification will be sent to the current landlord and the previous landlord if the applicant resides less than three years with the current landlord.

4) A Landlord-Tenant court history will be requested on each applicant. F) Home visits will be conducted by the Owner’s representative at a

prearranged time. All family members who will occupy the unit must be present at this meeting. Recommendations for or against tenancy will be based on an informal visit, but at the same time, our representative will be observing the cleanliness and maintenance of the surroundings (taking into consideration the landlord’s responsibilities) and the physical appearance

of the applicants and their interaction with family members. Also to be taken into consideration:

1) Habits which could be detrimental to the property or other residents- such as poor care of appliances, plumbing fixtures, etc.

2) Poor health habits.

3) Evidence of negligent dependant care. Applicants requiring the Assistance of a live in aide must have one.

4) Physical abuse of the facilities.

5) Any evidence of conduct which can be detrimental to the property.

NOTE: That poor quality or shabby furnishings are not a basis for rejection. G) Adverse police record, which would be indicated by the following:

1) Any drug or alcohol related arrests. 2) Any arrests for assault and/or battery. 3) Any felony conviction.

4) Any arrests or convictions for public lewdness.

5) Any arrests or convictions for child abuse, endangerment of spousal abuse, stalking or harassment.

H) Any indication that the applicant cannot adequately sustain decent levels of habitability or control of dependant so as to adversely affect the property or other residents.

I) A personal interview that indicates an unstable or potentially hazardous relationship between the applicant household and other residents.

J) A personal interview and/or information that indicates the applicant or any household member would be a threat to the safety and well being of the property and/or other residents.

K) A personal interview and/or information that indicates the applicant will be unable to comply with the terms of this lease agreement.

Each rejected applicant will be promptly notified in writing of the reason(s) for rejection. This notice will advise the applicant that he/she may, within fourteen (14) calendar days

of receipt of the notice, request in writing a meeting to discuss the reasons for rejection. Should the applicant request a meeting to discuss the rejection; it would be conducted by a

member of the management staff that was not involved in the original decision to reject the applicant. The applicant will be advised in writing of the results of this meeting within five (5) days.

Requesting a meeting to discuss the reasons for rejection will in no way prevent the applicant from exercising any legal rights he/she may have. The applicant will be advised of this at the time of rejection.

Brookside Terrace will keep the following materials on file for at least three years:

• Original application

• Initial rejection notice

• Any applicant reply

• Owner’s final response

• All interview and verification information

UNIT TRANSFERS

The decision to allow unit transfers will be at the sole discretion of the management, based upon changes in family composition and/or possible medical conditions. Families currently living in Brookside Terrace may request a voluntary transfer, at which time their name will be added to an internal waiting list for a particular unit size or type. In order to alleviate rental loss to the Owner, these tenants must agree to pay an additional one-month’s basic rent on the apartment currently occupied. These charges must be paid at the time of lease signing for the transfer unit.

Tenants who must move to a larger or smaller unit because of changes in family composition or possible medical condition, verified by a medical doctor, will be placed on the internal waiting list with no charge to them at their move to a different sized unit. If family size changes, we have the right to transfer the tenant to a larger or smaller unit upon a thirty (30) day notice.

Tenants on the internal waiting list will have priority over new applicants. Also, tenants referred to in paragraph 2 above, will be given priority over those requesting a voluntary transfer.

NO PET POLICY

NO PETS, OF ANY KIND, ARE PERMITTED ON THE PREMISES (INCLUDING VISITING PETS) OR IN THE UNIT.

PETS SHALL INCLUDE, BUT NOT BE LIMITED TO, DOGS, CATS, BIRDS, REPTILES, MICE, RODENTS, FERRETS, HAMSTERS OR INSECTS.