Application for acceptance into Tonquish Creek Manor

application for consideration for acceptance into Tonquish Creek Manor

Attached is an application for consideration for acceptance into Tonquish Creek Manor, a senior citizen building located in downtown Plymouth. The building has 104 single bedroom apartments and is subsidized through the Department of Housing and Urban Development (HUD). Anyone who feels they may be qualified and can meet the eligibility requirements is encouraged to submit an application.

The following are basic eligibility requirements:

You must qualify as a senior – i.e., be 62 years of age or older. All household members must be 62 years of age or older.
Your annual income limits must not be more than:
One Person: $53,050 | Two Persons: $60,600

There are no asset limits required for admission. However, in determining net family assets, Tonquish Creek Manor, LLC shall include the value or any asset disposed of by an applicant or tenant for less than fair market value, during the two preceding years.

Applications shall be arranged in accordance with priority factors established by the Federal Government and the Tonquish Creek Manor, LLC as follows:
1. Resident of the City of Plymouth
2. Resident of City of Plymouth Township

TONQUISH CREEK MANOR, LLC, SHALL NOT DENY ANYONE THE OPPORTUNITY TO APPLY FOR ADMISSION, NOR DENY AN ELIGIBLE APPLICANT THE OPPORTUNITY TO LEASE A DWELLING UNIT SUITABLE TO THEIR NEEDS IN ANY PROJECT OF TONQUISH CREEK MANOR, LLC, ON THE BASIS OF RACE, CREED, COLOR, SEX, HANDICAP OR NATIONAL ORIGIN.

Upon receipt of your application, your name will be placed on our waiting list if you meet the basic requirements. At a later date, an interview will be required to determine eligibility. At the time of the interview, you will be required to produce documentation verifying the information given on your application.

It is the goal of the Tonquish Creek Manor, LLC to advise all concerned of their qualifications and selection to participate in this program. However, it is the responsibility of the applicant to notify this office of any change in address, telephone number or other pertinent information.

FAILURE TO KEEP THIS OFFICE INFORMED OF CHANGES MAY RESULT IN THE REMOVAL OF THIS APPLICATION FROM THE ACTIVE WAITING LIST

Angela Morey, Housing Manager

Tonquish Creek Manor Application

Head of Household(Required)

Last Name, First Name

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

How long have you lived at this address?

Phone(Required)

Date of Birth(Required)

Last four digits of SSN(Required)

Place of Birth

Spouse/Other Adult

Relationship

Date of Birth

Are you a resident of the City of Plymouth or Township(Required)

Yes

Will a disability require special housing needs?(Required)

Yes

Please Explain(Required)

Are you or your spouse disabled as per the social security definition?(Required)

Yes

Permanently

Temporarily

Have you ever lived in subsidized housing or participated in a section 8 rental assistance program?(Required)

Yes

Where?(Required)

Have you or anyone in your househeld EVER been convicted of a felony?(Required)

Yes

Please Explain(Required)

List All Monthly Income Before Deductions For Yourself and Your Spouse.(Required)

List Income Specifically for each of these five categories: Employment Income, Social Security, Pension, Public Assistance, and Other Income.

List all assets of household members, including savings and checking accounts, certificates of deposit, stocks, bonds, real estate, life insurance and other capital investments.(Required)

Information on each Asset should include Institution where account is held, type of asset, current balance/value, and interest rate.

List any out-of-pocket medical and/or prescription expenses.(Required)

This includes Medicare/Medicaid Premiums, Supplemental Insurance, Prescriptions, etc. Include a generic description and the monthly amount.

Current Landlord

Name/Management Company

Address

Phone

Are you related to the landlord?(Required)

Yes

How are you related?(Required)

Previous Address

Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants

Instructions: Optional Contact Person or Organization: You have the right by law to include as part of your application for housing, the name, address, telephone number, and other relevant information of a family member, friend, or social, health, advocacy, or other organization. This contact information is for the purpose of identifying a person or organization that may be able to help in resolving any issues that may arise during your tenancy or to assist in providing any special care or services you may require. You may update, remove, or change the information you provide on this form at any time. You are not required to provide this contact information, but if you choose to do so, please include the relevant information on this form.

Do you want to include this information?(Required)

I wish to include this information

I do not want to include this information

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING

Name(Required)

First Last

Mailing Address(Required)

Street Address City State ZIP Code

Phone Number

Relationship to Applicant

Untitled(Required)

Emergency

Unable to contact you

Eviction from unit

Late payment of rent

Assist with Recertification Process

Change in lease terms

Change in house rules

Other:

Reason(Required)

If you are approved for housing, this information will be kept as part of your tenant file. If issues arise during your tenancy or if you require any services or special care, we may contact the person or organization you listed to assist in resolving the issues or in providing any services or special care to you.

The information provided on this form is confidential and will not be disclosed to anyone except as permitted by the applicant or applicable law.

Section 644 of the Housing and Community Development Act of 1992 (Public Law 102-550, approved October 28, 1992) requires each applicant for federally assisted housing to be offered the option of providing information regarding an additional contact person or organization. By accepting the applicant’s application, the housing provider agrees to comply with the non-discrimination and equal opportunity requirements of 24 CFR section 5.105, including the prohibitions on discrimination in admission to or participation in federally assisted housing programs on the basis of race, color, religion, national origin, sex, disability, and familial status under the Fair Housing Act, and the prohibition on age discrimination under the Age Discrimination Act of 1975.

Smoking Policy

The Tonquish Creek Manor, located at 1160 Sheridan, Plymouth, MI 48170 has been declared a smoke free building. Smoking is not permitted in any area of the building including apartments. Smoking is only permitted 50 feet or more from the perimeter of the building. All tenants and guests must abide by the following rules and regulations.

1. No smoking anywhere in the building including apartments. Failure to follow this policy will be considered a lease violation.

2. “No Smoking” signs are posted outside of the building.

3. Smoking outside will be limited to 50 feet or more from the perimeter of the building.

4. If a resident smells tobacco smoke in any place in the building, they are to report this to the office as soon as possible. Management will seek the source of the smoke and take appropriate action.

5. New tenants will be given two (2) copies of the smoking policy. After review, the tenant will sign both copies and return one to the Tonquish Creek Manor, LLC’s office. This copy will be placed in the tenant’s file.

Applicant/Tenant Certification(Required)

I have read and understand the above smoking policy and I agree to comply fully with the provisions. I understand that failure to comply may constitute reason for termination of my lease.