New Resident Application (NY)

Interested in becoming a part of the CRM community?

Fill out the online application below.

Please note that all applicants will be required to visit the office to further complete their application process.

"*" indicates required fields

Step 1 of 8

Application for Admission to: CRM Rental Mgmt. Co.

If you need a reasonable accommodation due to 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 the 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 / companion animal. The occupancy of a unit is subject to possession of the unit being delivered by the 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, applicants demonstrating the ability to pay required rent and other criteria depending on the property program requirements. 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.

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.

Select the property you are applying to*

Head of Household

Name*

First Middle Last

Social Security Number*

Date of Birth*

Current Address*

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

Primary Phone*

Work Phone

Primary Email*

Current Landlord

Current Landlord Address

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

Landlord Phone

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

What is your citizenship status?*

If eligible non-citizen, what is your alien registration number?*

YOU MUST SELECT A PROPERTY AT THE TOP OF THIS FORM BEFORE CONTINUING TO THE NEXT PAGE

Income Information

Present Employer*

If none please enter N/A

Employer Address

If none please enter N/A

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

Phone

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 / Province / Region ZIP / Postal Code Country

Phone

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 NY state*

If only NY please enter N/A

New York State Housing and Anti-Discrimination Disclosure Form

Federal, State and local Fair Housing and Anti-discrimination Laws provide comprehensive protections from discrimination in housing. It is unlawful for any property owner, landlord, property manager or other person who sells, rents or leases housing, to discriminate based on certain protected characteristics, which include, but are not limited to race, creed, color, national origin, sexual orientation, gender identity or expression, military status, sex, age, disability, marital status, lawful source of income or familial status. Real estate professionals must also comply with all Fair Housing and Anti-discrimination Laws.

Real estate brokers and real estate salespersons, and their employees and agents violate the Law if they:

Discriminate based on any protected characteristic when negotiating a sale, rental or lease, including representing that a property is not available when it is available.
Negotiate discriminatory terms of sale, rental or lease, such as stating a different price because of race, national origin or other protected characteristic.
Discriminate based on any protected characteristic because it is the preference of a seller or landlord.
Discriminate by “steering” which occurs when a real estate professional guides prospective buyers or renters towards or away from certain neighborhoods, locations or buildings, based on any protected characteristic.
Discriminate by “blockbusting” which occurs when a real estate professional represents that a change has occurred or may occur in future in the composition of a block, neighborhood or area, with respect to any protected characteristics, and that the change will lead to undesirable consequences for that area, such as lower property values, increase in crime, or decline in the quality of schools.
Discriminate by pressuring a client or employee to violate the Law.
Express any discrimination because of any protected characteristic by any statement, publication, advertisement, application, inquiry or any Fair Housing Law record.

YOU HAVE THE RIGHT TO FILE A COMPLAINT
If you believe you have been the victim of housing discrimination you should file a complaint with the New York State Division of Human Rights (DHR). Complaints may be filed by:

Downloading a complaint form from the DHR website: www.dhr.ny.gov;
Stop by a DHR office in person, or contact one of the Division’s offices, by telephone or by mail, to obtain a complaint form and/or other assistance in filing a complaint. A list of office locations is available online at: https://dhr.ny.gov/contact-us, and the Fair Housing HOTLINE at (844)-862-8703.

You may also file a complaint with the NYS Department of State, Division of Licensing Services. Complaints may be filed by:

Downloading a complaint form from the Department of State’s website https://www.dos.ny.gov/licensing/complaint_links.html
Stop by a Department’s office in person, or contact one of the Department’s offices, by telephone or by mail, to obtain a complaint form.
Call the Department at (518) 474-4429.

There is no fee charged to you for these services. It is unlawful for anyone to retaliate against you for filing a complaint.

For more information on Fair Housing Act rights and responsibilities please visit https://dhr.ny.gov/fairhousing and https://www.dos.ny.gov/licensing/fairhousing.html.

This form was provided to me by:

of (community)

(I)/(We)

(Buyer/Tenant/Seller/Landlord) acknowledge receipt of a copy of this disclosure form:

Landlord Signature

Date

Tenant Signature

Date

Real Estate broker and real estate salespersons are required by New York State law to provide you with this Disclosure.

This form should be signed by office manager and applicant/tenant and then filed in the households correspondence file.

If the applicant/tenant refused to sign enter â€œdeclined to signâ€ on the applicant signature line. Office Manager should still sign and date and file in households correspondence file.

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

This field is for validation purposes and should be left unchanged.

New Resident Application (NY)

Interested in becoming a part of the CRM community?

Head of Household

YOU MUST SELECT A PROPERTY AT THE TOP OF THIS FORM BEFORE CONTINUING TO THE NEXT PAGE

Household Information

Adult 1

Adult 2

Adult 3

Adult 4

Child 1

Child 2

Child 3

Child 4

Student Status Information

Previous Address Information

Answer The Following

Income Information

All Income Must Be Reported

Instructions

Asset Information

Child Care Expenses Information

Elderly / Disabled Household Information

Medical Expense Information

Reasonable Accommodation Information

Applicant Certification (Read Carefully)

SUPPLEMENT TO APPLICATION FOR FEDERALLY ASSISTED HOUSING

New York State Housing and Anti-Discrimination Disclosure Form