New Resident Application (MA) - CRM Rental Management

Interested in becoming a part of our Knitting Mill community?

Fill out the online application below.

Please note that there may be further forms required. We will contact you regarding this process. Thank you for your application.

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Application for Admission to:

Knitting Mill Apartments
69 Alden Street
Fall River, MA 02723
Phone: 800-410-2912
Fax: 315-336-0371
Massachusetts TTY: 800-439-2370

Please contact Management if you need help understanding this document.
Contacte por favor la oficina de gestión si usted necesita ayuda a comprender este documento.
Por favor contate o escritorio de gerencia se deve ajudar entendimento este documento.

If you need a reasonable accommodation due to a disability we can provide an alternative method for your application process upon your request. Please answer all questions and include all information requested. If a question does not pertain to you, please indicate N/ A in answer space. FAILURE TO DO SO WILL RESULT IN THE APPLICATION BEING CONSIDERED INCOMPLETE AND THEREFORE WILL NOT BE PROCESSED. Make certain you carefully read and understand all items before you submit this application. All information is confidential. Pets are only allowed in our senior citizen properties or for persons with disabilities who require a service animal. The occupancy of a unit is subject to possession of unit being delivered by present occupant. It is understood that this application and each prospective occupant is subject to approval and acceptance. Approval is based on, but not limited to, acceptable credit history and demonstrated ability to pay required rent. When also approved and accepted the applicant agrees to execute a lease before possession is given and to pay the first month's rent plus the required security deposit.

AT LEAST ONE HOUSEHOLD MEMBER MUST BE 62 YEARS OF AGE OR OLDER

ALL ADULTS 18 YEARS OF AGE AND OLDER LISTED ON THE APPLICATION WILL BE REQUIRED TO SIGN THE APPLICATION AND ITS ATTACHMENTS AS WELL AS PROVIDE A PICTURE IDENTIFICATION.

Knitting Mill Apartments has a strict No Smoking policy.

Head of Household

Name*

First Middle Last

Social Security Number*

Date of Birth*

Current Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Work Phone*

Must enter area code. Enter phone number like 1234567890 or 123-456-7890. If none please enter N/A.

Primary Email*

Current Landlord

Current Landlord Address

Street Address Address Line 2 City State ZIP Code

Landlord Phone

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Start Date at Current Address

Reason for Leaving

Monthly Rent*

No special characters or periods. If not applicable please enter "0".

Did This Include Utilities?

Is your current landlord or any of your previous landlords a relation to you?

Yes

If answered yes, please explain relation

Are you homeless?

Yes

An applicant is Homeless if she/he meets the following definitions:

is without a place to live or is in a living situation in which there is a significant, immediate and direct threat to the life or safely of the applicant or a household member which situation would be alleviated by placement in a unit of appropriate unit size.
has made reasonable efforts to locate alternative housing
has not caused or substantially contributed to the safety-threatening or life-threatening situation; and
has pursued available ways to prevent or avoid the safety-threatening or life-threatening situation by seeking assistance through the courts or appropriate administrative or enforcement agencies.

I certify that I am

living in a place not meant for human habitation, such as cars, parks, sidewalks, abandon buildings or on the street.

staying in an emergency shelter for homeless persons.

in a transitional or supportive housing program for homeless persons and/or in any of the above places but is spending a short time (up to 30 consecutive days) in a hospital or other institution.

a temporary resident in a hotel/motel through sponsorship by a social service agency or hotel voucher program. No subsequent residence has been identified and the person lacks the resources and support needed to obtain housing.

being evicted or forced out within a week from a private dwelling unit, no subsequent residence has been identified and the person lacks the resources and support needed to obtain housing.

being discharged from an institution, such as mental health or substance abuse treatment facility or jail or prison in which the person has been a resident for more than 30 consecutive days and no subsequent residence has been identified and the person lacks the resources and support networks necessary to obtain housing.

fleeing a domestic violence housing situation and no subsequent residence has been identified and the person lacks the resources and support necessary to obtain housing.

Statement of current situation

Describe your housing situation for the past three years

Do you meet HUD's definition of Chronically Homeless as listed below?

Chronically homeless is defined as “an unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more OR has had at least four (4)episodes of homelessness in the past three (3) years.” To be considered chronically homeless a person must have been sleeping in a place not meant for human habitation (i.e. living on the streets) or in an emergency shelter.

Yes, I am chronically homeless.

No. I am currently homeless, but not chronically homeless.

The Fair Housing Act/Federal law prohibits discrimination in the sale, rental or financing of housing on the basis of race, color, national origin, sex, religion, age, disability, marital or familial status. Under Massachusetts law it is illegal to discriminate in housing based on Section 8 or public assistance, sexual orientation, gender identity and expression, marital status, military or veteran status, age or ancestry. Applicants may file any complaints of discrimination to the U.S. Dept. of Housing & Urban Development, Assistant Secretary for Fair Housing & Equal Opportunity, Washington DC 20410 and Massachusetts Fair Housing Center, 57 Suffolk Street, Holyoke MA 01040.

Household Information

How many adults, including yourself, will reside in the household*

Adult 1

First Name*

Middle Name*

If none please enter N/A

Last Name*

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

Source of Income

Adult 2

First Name*

Middle Name*

If none please enter N/A

Last Name*

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

Source of Income

Adult 3

First Name*

Middle Name*

If none please enter N/A

Last Name*

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

Source of Income

Adult 4

First Name*

Middle Name*

If none please enter N/A

Last Name*

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

Source of Income

Will any children be residing in the household?*

Yes

How many children will reside in the household?*

Child 1

Name*

First Middle Last

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

School Name

Child 2

Name*

First Middle Last

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

School Name

Child 3

Name*

First Middle Last

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

School Name

Child 4

Name*

First Middle Last

Date of Birth*

mm/dd/yyyy

Social Security Number*

Sex

Male

Female

Relationship

School Name

Do you have full custody of all the children noted above?*

Absent Parent Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Based on number of household members listed above, how many bedrooms are you applying for?*

The Individual listed as Head of Household on this application should complete the following

White

Black or African American

American Indian/ Alaskan Native

Asian

Native Hawaiian or Other Pacific Islander

Race of Head of Household:

Ethnicity of Head of Household

Hispanic

Non-Hispanic

N/A

Do you own a car?*

If answer is yes, please list the following: License #, State of Registration, Model/ Type of Vehicle*

Student Status Information

Are any household members listed on this application enrolled as a student in an institute of higher education?*

*(Institutes of higher education include post-secondary vocational institutions, proprietary institutions of higher education which prepare students for gainful employment in a recognized occupation, and accredited post-secondary colleges and universities.)

If yes, please list all household members who are currently or intend to be enrolled in an institute of higher education

Please Include Name of Individual Enrolled, Date of Birth and Name of School/ Institute

Previous Address Information

List two previous addresses.

If another person will be responsible for renting the apartment with you, list his/her current and previous two addresses as well as the landlord's information.

1st Previous Address*

Street Address Address Line 2 City State ZIP Code

Start Date Of Residing At This Address*

End Date*

Reason for Leaving*

Landlord's Name*

Phone*

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Landlord's Address

Street Address Address Line 2 City State ZIP Code

2nd Previous Address

Street Address Address Line 2 City State ZIP Code

Start Date Of Residing At This Address

End Date

Reason For Leaving

Landlord's Name:

Phone

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Landlord's Address

Street Address Address Line 2 City State ZIP Code

Are any household members now living in housing with a subsidized program*

Is this assistance...

List Names of Complex(s)

Please Include the Name of the Complex(s), the Address(es), Dates Resided, Manager/ Owner's Name and a Phone Number.

* Please note: Assistance cannot be made available to you at this property while you are receiving assistance for another residence.

Answer The Following

Have you,spouse or co-tenant ever been evicted, or currently being evicted from housing?*

If yes, explain*

Have you, spouse or co-tenant ever committed any fraud in a federally assisted housing program or been requested to repay money for knowingly misrepresenting information for such housing programs?*

If yes, explain*

Have you, spouse or co-tenant ever been evicted from any federally assisted housing unit(s) for drug related criminal activity?*

If yes, please list address, date and reason for eviction*

Have you or any member of the household ever been convicted of a crime other than a traffic violation?*

If yes, please explain*

Have you or any member of the household ever been convicted of a felony?*

If yes, please list dates and crimes, locations, jail/ prison time served and probation/parole status*

Have you or any member of the household ever been convicted of the illegal manufacture, use or distribution of a controlled substance?*

If yes, please explain*

Are any household members currently using illegal substances?*

If yes, please explain*

Have you or a household member ever been convicted of a sex related crime or are subject to lifetime registration in a State sex offender registration program?*

If yes, please list all states that you have resided in last seven years*

Have you or any member of the household ever used another social security number other than the one you were assigned?*

If yes, please explain*

Income Information

Present Employer*

If none please enter N/A

Employer Address*

Street Address Address Line 2 City State ZIP Code

If none please enter N/A

Phone*

Must enter area code. Enter phone number like 1234567890 or 123-456-7890. If none please enter N/A.

How Long Employed*

If none please enter N/A

Job Title*

If none please enter N/A

Supervisor*

If none please enter N/A

Gross Weekly Wage*

If none please enter "0".

Hourly Rate*

If none please enter "0".

Avg. Hours Worked Per Week*

If none please enter "0".

Spouse or Co-Tenant Current Employer

Employer Address

Street Address Address Line 2 City State ZIP Code

Phone

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

How Long Employed

Job title

Supervisor

Gross Weekly Wage

Hourly Rate

Avg. Hours Worked Per Week

All Income Must Be Reported

Instructions

* Listed below are the different sources of income. Please fill in each box with the gross monthly income. If it does not apply to you, please fill in the blank with the number "0".

Social Security*

If none please enter "0".

SSI*

If none please enter "0".

Pension's*

If none please enter "0".

Public Assistance*

If none please enter "0".

Support/Alimony*

If none please enter "0".

Trust Funds*

If none please enter "0".

Disability*

If none please enter "0".

Unemployment Insurance*

If none please enter "0".

Workman's Compensation*

If none please enter "0".

Wages (if not previously listed)*

If none please enter "0".

Interest From Savings*

If none please enter "0".

Interest from Checking Accounts*

If none please enter "0".

Dividends From Stocks/ Bonds*

If none please enter "0".

Income Property Owned*

(List Market Value) If none please enter "0".

Military Reserves*

If none please enter "0".

Money paid to you by Higher Education ( Grants/Scholarships)*

If none please enter "0".

Any monies paid to anyone in the household by someone not living in the household*

(including any bills paid by someone else outside the household) If none please enter "0".

Other ( Specify Source)*

If none please enter "0".

Did you submit Federal Income Taxes in the last year?*

If yes, what was your filing status?*

Please list all states that household members have lived in besides Massachusetts*

If only MA please enter N/A

Asset Information

Instructions
List ALL assets and investments owned by ALL members of the household. Include all savings accounts, checking accounts, IRA's Keogh accounts, annuities, certificate of deposits, real estate owned ( must provide full market value of all real estate owned), stocks, bonds, and all other assets owned.

Have you or any member of the household sold or disposed of any asset(s) valued over $1,000 in the last two years?*

If yes, please list type of asset ( e.g. money/land/house)*

Market value when sold/disposed ( must be able to verify)*

Amount sold/disposed for:*

Date of transaction

Name/ Address of Broker

Checking Account*

Value ( Full Market for Real Estate)

Bank Name/ Address

Savings Account*

Value ( Full Market for Real Estate)

Bank Name/Address

Certificate of Deposit*

Value ( Full market for Real Estate)

Bank Name/ Address

IRA/ Keogh/401K*

Value ( Full Market for Real Estate)

Bank Name/ Address

Real Estate*

Value ( Full Market for Real Estate)

Bank Name/Address

Stocks/Bonds*

Value ( Full Market for Real Estate)

Bank Name/Address

Life Insurance*

Value ( Full Market for Real Estate)

Bank Name/ Address

Trusts*

Value ( Full Market for Real Estate)

Bank Name/ Address

Burial Fund*

Value ( Full Market for Real Estate)

Bank Name/ Address

Child Care Expenses Information

Do you pay childcare for a child 12 years old of younger so that you can work or attend school?

If yes, what is the weekly cost of care?

Name of Childcare Provider

Address of Childcare Provider

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Medical Expense Information

Please list all medical expenses you expect to incur in the next 12 months that will NOT BE PAID OR REIMBURSED by Medicare or any kind of health insurance and which you expect to be continuous.

Health Insurance*

If none please enter N/A

Name*

Monthly Amount

Health Insurance

Name

Monthly Amount

Medicaid Spend Down

Monthly Amount

Prescriptions

(not covered by insurance; used for ongoing medical problems)

Monthly Amount

Unpaid Hospital Bills for which you are making monthly payments.
(Only amounts not covered by nor reimbursed by insurance or other agency)

Total Amount Owed

Monthly Payment Amount

Reasonable Accommodation Information

This information is voluntary.
CRM Rental Management, Inc. is a management company that provides low rent housing to eligible households, elderly households and single people. CRM has a legal obligation to provide "reasonable accommodations" to applicants if they or any household member have a disability or handicap. You may request a reasonable accommodation at any time, during the application process or after admission. If you would prefer to not discuss your situation with management, that is your right.

Does any member have special housing needs which require any of the following: (check applicable items)

One Level Unit

Unit for Vision Impaired

Unit for Hearing Impaired

Barrier-free Unit

One level Unit

Br/Bath on 1st Floor

Live-In Aide

Service Animal

Ramp

Instructions
Please complete the following to help us identify which forms of advertisement or outreach we are using in accordance with our AFHMP is working to reach our targeted areas.

How did you hear about our community?

Newspaper Advertisement

Friend of Current/Former Resident

Referral from Community Resource

Internet

Brochure/Flyer

Other

Please explain your answer selected from the list above (name of newspaper etc.)

Applicant Certification (Read Carefully)

Tenant Certification
I/we hereby certify that I/we do not and will not maintain a separate, subsidized rental unit in another location. I/we understand I/we must pay a security deposit for this apartment prior to occupancy . I/we certify that the housing I/we will occupy is/will be my/our permanent residence. I/we understand that we must provide valid proof of social security numbers for all household members prior to occupying a unit.

Tenant Understanding
I/we understand that eligibility for housing will be based on either the USDA, Rural Development, or the Department of Housing and Urban Development's eligibility criteria and CRM Rental management's resident selection criteria. I/we understand that this application in no way ensures occupancy and that my /our application can be rejected based on, but not limited to (1) a history of unjustified and/or chronic nonpayment of rent and/or financial obligations; (2) a history of living or housekeeping habits that woulds pose a direct threat to the health and safety of other individuals or whose tenancy would result in substantial physical damage to the property of others;(3) a history of disturbance of neighbors; (4) a history of violations of the terms of previous rental agreements, especially those resulting in eviction from housing or termination from a residential program; (5) police records indicating any type of criminal activity or conviction; and (6) any records which show the applicants behavior to be unacceptable , even if it is a manifestation of an applicant's disability; (7) a credit score lower than that set for this project by an online screening website.

I/we certify that the information given in this application is true to the best of my/our knowledge.*

I have read and understood the terms stated above.

I/we understand that any false information or any omission of any significant information is punishable by law, and could be grounds for cancellation of this application or termination of residency after occupancy.

Head of Household Electronic Signature*

By typing your name, you are verifying that all the information submitted is true and that you understand the terms and regulations stated in this application.

Date*

Spouse or Co Tenant Signature

Date

Other Adult Household Member Signature

Date

Other Adult Household Member Signature

Date

Legal Notes
"Title 18, Section 1001 of the US Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. HUD and any owner ( or any employee of HUD or the owner) may be subject to penalties for unauthorized disclosures or improper uses of information collected based on the consent form. Use of the information collected based on this verification form is restricted to the purposes cited above. Any person who knowingly or willingly requests, obtains or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more than $5,000. Any applicant or participant affected by negligent disclosure of information may bring civil action for damages and seek other relief, as may be appropriate, against the officer or employee of HUD or the owner responsible for the unauthorized disclosure or improper use. Penalty provisions for misusing the social security number are contained in the Social Security Act at 208 (a), (6), (7), and (8). Violation of these provisions are cited as violations of 42 U.S.C. 408 (a), (6),(7), and (8)."

Applicant/Co-Applicant Consent Form

I/we hereby consent to allow Knitting Mill Apartments through its’ designated agent and its’ employees, to obtain and verify my credit information (including a criminal background and sex offender status) for the purpose of determining whether or not to lease me/us an apartment. I/we understand that should I/we lease an apartment, Knitting Mill Apartments will review my/our criminal background and sex offender status yearly at re-certification.

Head of Household Electronic Signature*

Date*

Spouse or Co Tenant Signature

Date

Other Adult Household Member Signature

Date

Other Adult Household Member Signature

Date

PENALTIES FOR MISUSING THIS CONSENT
“Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government. HUD and any owner (or any employee of HUD or the owner) may be subject to penalties for unauthorized disclosures or improper uses of information collected based on the consent form. Use of the information collected based on this verification form is restricted to the purposes cited above. Any person who knowingly or willingly requests, obtains, or discloses any information under false pretenses concerning an applicant or participant may be subject to a misdemeanor and fined not more than $5,000. Any applicant or participant affected by negligent disclosure of information may bring civil action for damages and seek other relief, as may be appropriate, against the officer or employee of HUD or the owner responsible for the unauthorized disclosure or improper use. Penalty provisions for misusing the social security number are contained in the Social Security Act at **208 (a) (6), (7) and (8).** Violations of these provisions are cited as violations of 42 USC **408 (a) (6), (7) and (8).**

Rental History Consent Form

I/we hereby consent to allow Knitting Mill Apartments through its’ designated agent and its’ employees to obtain and verify my landlord references.

Head of Household Electronic Signature*

Date*

Spouse or Co Tenant Signature

Date

Other Adult Household Member Signature

Date

Other Adult Household Member Signature

Date

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING

OMB Control # 2502-0581
Exp. (11/30/2015)

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.

Check this box if you choose not to provide the contact information.

Applicant Name

Mailing Address

Street Address Address Line 2 City State ZIP Code

Telephone #

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Cell Phone #

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Name of Additional Contact Person or Organization

Address

Street Address Address Line 2 City State ZIP Code

Telephone #

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

Cell Phone #

Must enter area code. Enter phone number like 1234567890 or 123-456-7890.

E-mail Address (if applicable)

Relationship to Applicant

Reason for Contact: (Check all that apply)

Emergency

Unable to contact you

Termination of rental assistance

Eviction from unit

Late payment of rent

Assist with Re-certification Process

Change in lease terms

Change in house rules

Other

Commitment of Housing Authority or Owner
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.

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

Legal Notification
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.

Electronic Signature of Applicant*

Date*

Select today's date from the calendar or enter date MM/DD/YYYY.

The information collection requirements contained in this form were submitted to the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The public reporting burden is estimated at 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Section 644 of the Housing and Community Development Act of 1992 (42 U.S.C. 13604) imposed on HUD the obligation to require housing providers participating in HUD's assisted housing programs to provide any individual or family applying for occupancy in HUD-assisted housing with the option to include in the application for occupancy the name, address, telephone number, and other relevant information of a family member, friend, or person associated with a social, health, advocacy, or similar organization. The objective of providing such information is to facilitate contact by the housing provider with the person or organization identified by the tenant to assist in providing any delivery of services or special care to the tenant and assist with resolving any tenancy issues arising during the tenancy of such tenant. This supplemental application information is to be maintained by the housing provider and maintained as confidential information. Providing the information is basic to the operations of the HUD Assisted-Housing Program and is voluntary. It supports statutory requirements and program and management controls that prevent fraud, waste and mismanagement. In accordance with the Paperwork Reduction Act, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information, unless the collection displays a currently valid OMB control number.

Privacy Statement:
Public Law 102-550, authorizes the Department of Housing and Urban Development (HUD) to collect all information (except the Social Security Number (SSN)) which will be used by HUD to protect disbursement data from fraudulent actions.

Know Your Rights
A Guide to Rights in Employment & Housing
Massachusetts residents with criminal records often face unique challenges when re-entering society. Among these challenges are barriers to securing employment and housing – key parts of productive participation in our society and critical pathways to economic security. Because we recognize the importance of access to employment and housing, we have prepared this guide to help educate residents on their basic rights in these areas.

Please click here to read the guide.

I have read and understand the "Know Your Rights" guide

Language Identification

Please click here to view the language identification flashcard.

Choose your language*

I have read and understand the language sheet

By submitting this application, i hereby consent for online screenings to be run and any other screenings be conducted, including but not limited to landlord screenings, as outlined in the tenant selection plan.*

I Agree