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Personal Information
First Name
Last Name
Contact Information
Email Address
Home Phone
Cell Phone
Work Phone
Preferred Method of Communication
Email
Phone
Address
Address Line 2
City
State
Zip Code
Residency & Employment
Are you a Resident of Glendale?
Yes
No
How will you verify your residency in Glendale?
Copy of current lease, residential telephone, PG&E or water bill with Glendale address in applicant’s name
Signed Tax Returns
California Drivers’ License or Identification Card
Other
Do you work in Glendale?
Yes
No
What is the name of your Employer?
How will you verify your employment in Glendale?
Copies of paycheck(s), Employment Verification Letter from HR department
Complete signed copy of Tax Returns including W-2s and 1099s
Offer letter from employer
Other
Section 8 Funding
Do you have a Section 8 Voucher?
Yes
No
Section 8 Cert Number (optional)
Section 8 Cert Date (optional)
Household Information
Requested Bedroom Size
Select One
Studio
1 Bedroom
2 Bedroom
3 Bedroom
Number of Occupants
Annual Gross income for Household
Your yearly income before any deductions
Source(s) of Income
Wages/Salaries
Self Employment
Pension/Benefits/Public Assistance
Assets
Other
Not Applicable
Check all that apply
Certification of Applicant(s)
I/We understand that:
A. This pre-application will be entered into a lottery and sorted by preferences set by the City of Glendale. The first priority preference is given to those who live and work in Glendale. The second priority preference is given to those who either live or work in Glendale. Pre-applicants with a first priority preference will be placed ahead of those with second priority and those with no preference eligibility. Those with a second priority preference will be placed ahead of those with no preference eligibility.
B. Based on my eligibility for a preference, I may be placed ahead of those with a higher lottery number or behind those who have a lower lottery number.
C. Any and all information provided will be used to determine eligibility for substantial public benefits and any and all information contained in the records kept by the Program can and will be used for monitoring, auditing and establishing (my/our) eligibility and priority for the Affordability Program; otherwise this information is confidential.
D. Verifiable documentation supporting the statements made herein is required prior to renting an affordable housing rental unit.
E. If there are any false statements, or misrepresentations made on this submission, I /We will relinquish all rights to participate the affordable housing rental program.
I/We certify the following:
A. That the information provided in this submission is true and correct, and complete to the best of my knowledge. I/ We have not knowingly omitted any pertinent information.
B. That the combined household income is below the maximum household income limit for my household size.
C. That I/We will occupy the Affordable Housing Rental Unit as my/our primary residence.
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