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
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
