Full Name*
Full Address*
Phone Number*
Email Address*
Number of Bedrooms in Your Apartment*
Number of people living with you (including self)* ---1234567
Monthly Rent Amount*
Amount of Support Requested*
Reason for Support Request*
Landlord’s/Property Manager’s Name and Address*
Relationship to Applicant 1*
Full Name
Monthly Income
Rent Contribution Amount
Relationship to Applicant 2
Relationship to Applicant 3
Relationship to Applicant 4
Monthly Income $
Rent Contribution Amount $
Relationship to Applicant 5
Relationship to Applicant 6
Relationship to Applicant 7
Have you or your family received S.H.A.R.E. rental assistance in the past 12 months? Yes Yes
YesNo
YesNosure
Birth Month and Day
Ethnicity SelectWhite.Hispanic or Latino.Black or African American.Native American or American Indian.Asian / Pacific Islander.Other.
Yes This is my application and all of the information in it is true, correct and complete
Yes I permit Key Community Housing to obtain a copy of my lease, my photo ID and proof of income to support the verification of the information in this application to assess eligibility for rental assistance. I understand this may take up to 3 business days before a decision is made.
Yes I understand that, if awarded, rental assistance funds will be paid directly to the leasing office of where I reside instead of to me and that this application does not guarantee rental assistance
Signature of Main Applicant
Date
