Dear Rental Applicants:

 

 

Our rooming houses are subsidized by Resources for Communities And People,

(RCAP Solutions), which means that if you are accepted by WCHR and RCAP Solutions you will pay 30% of your monthly gross income towards the rent and RCAP Solutions will pay the remainder of the rent through rental assistance.

 

Please answer the following questions which will help us determine if you are eligible for the rental assistance:

 

 

 

 

1.  Are you a U.S. citizen or legal immigrant?  If not please explain?

 

 

 

 

 

 

 

2.  Have you ever received rental assistance, (public housing, Section 8) in the past?  If so, did you leave the housing in “good standing”? 

 

 

 

 

 

 

 

3.  Have you been arrested or convicted of any drug related or violent crimes within the past two (2) years?  Please explain.

 

 

 

 

 

 

 

 

  1. Can you provide documentation of your income, landlord references, personal references, and citizenship status?

 

 

 

 

 

 

 

Application Approval Guidelines for Subsidized Housing

 

Worcester Community Housing Resources will review the items listed below before approving applications for our subsidized rooms.  These items are reviewed for both determining the family or individual eligible for subsidized housing as well as approving applicant(s) by Worcester Community Housing Resources’ standards.

 

Income:  When looking at income, we look at two factors; does the individual meet the income guidelines for the subsidy, and does the individual have stable income? Income guidelines are as follows:

1 person- $25,100 per year

 

If your yearly income exceeds these figures, you will not be eligible for these subsidized rooms.

 

Credit:  We will obtain a recent credit history when reviewing your application.  This report may also include evictions and criminal convictions.

 

Landlord references: We require two (2) landlord references. 

 

Employment:  If income is from employment, we will require an employment reference verifying salary and indicating that employment will continue.

 

Other Income:  If income is received from sources other than employment, we require written documentation.  This may be either a print out, signed and stamped by the appropriate worker, or a signed letter on agency letterhead stating the monthly benefits you receive.

 

Bank Accounts: A letter from your bank on bank letterhead or a recent print-out from your bank stating your account balance and annual percentage rate if applicable.

 

Criminal History:  To be eligible for these subsidized rooms you cannot have any arrests or convictions for violent or drug related crimes within the past two years.  In addition certain convictions such as murder will deem you ineligible regardless of how long ago the crime was committed.  The housing agency responsible for subsidizing these apartments/rooms will administer a criminal history check for each adult in your household.  Any of the above mentioned arrests or convictions would deem you ineligible for these subsidized rooms.  In addition, we will also review your criminal history in determining if your application is approved.

 

Please be advised that our subsidized rooms are sober environments.  If you do not wish to live in a drug free/sober environment, please do not apply for a room with us.

 

 

 

 

Applicant Signature                                                                    Date

 

 

 


 

 

Rental Application- Rooming House

 

Name:________________________ SS#:_______________Date of Birth:____________

 

Present Address:__________________________________________________________

 

City:__________________________________State:________________Zip:__________

 

Home Phone Number:_________________Work Phone Number:___________________

 

All Rooming houses are single room occupancy- one person per room, no guests in the building between 10pm and 8am.  Absolutely no overnight guests allowed!

 

Housing History

 

Present Landlord:_______________________________Phone #___________________

 

Landlord’s address:________________________________________________________

 

City:____________________________State:________________Zip:________________

 

Present Rent:$_________________________

 

Date you moved in:______________________Date you moved out:_________________

 

Reason for Leaving:_______________________________________________________

 

 

Previous Landlord:_______________________________Phone #__________________

 

Previous Address(yours):___________________________________________________

 

Landlord’s address:________________________________________________________

 

City:____________________________State:________________Zip:________________

 

Previous Rent:$_________________________

 

Date you moved in:______________________Date you moved out:_________________

 

Reason for Leaving:_______________________________________________________

 

 


 

 

 

Previous Landlord:______________________________Phone #___________________

 

Previous Address (yours):___________________________________________________

 

Landlord’s address:________________________________________________________

 

City:____________________________State:________________Zip:________________

 

Previous Rent:$_________________________

 

Date you moved in:______________________Date you moved out:_________________

 

Reason for Leaving:_______________________________________________________

 

 

If any of your present or previous addresses were programs, please answer the following questions:

 

Are you presently in a program, if not, when were you in a program?________________

 

Please explain the type of program.___________________________________________

 

________________________________________________________________________

 

Did you complete the program successfully?____________________________________

 

If you did not complete the program, please explain why.__________________________

 

________________________________________________________________________

 

 

If you are currently homeless, please explain why:_______________________________

 

________________________________________________________________________

 

If you have been homeless within the past 5 years, please explain why:_______________

 

________________________________________________________________________

 

 


 

 

Present Employer:_________________________________Phone #:_______________

 

Address:________________________________________________________________

 

City:________________________State:________________Zip:____________________

 

Supervisor:______________________________ Length at job:_____________________

 

Hours worked per week:_________________________ Pay rate: $__________________

 

 

 

Other Income/Benefits:______________________Amount:______________________

 

Contact Person:______________________________ Phone#:______________________

 

 

 

Vehicle Make:_______________________________ Model:______________________

 

Year:________________________Color:_______________Plate#__________________

 

 

 

Do you have any bank accounts?:___________ type of account:____________________

 

Current balance:$_______________________

 

 

Personal References (do not include immediate family members)

Name                                                            Address                                                Phone#

 

1.______________________________________________________________________

 

2.______________________________________________________________________

 

3.______________________________________________________________________

 

 

Emergency Contact:_______________________________________________________

 

Phone #:________________________________________________________________

 

 

 

 

Worcester Community Housing Resources, Inc.

11 Pleasant Street Suite 300

Worcester, Ma 01609

(508) 799-0322

 

House Rules

2 Oread Street

866 Main Street

Tenant        initials

 

  1. Entering the building:  All tenants and guests must use the front door to enter and exit the building.                                                                                                                                       _______

 

  1. Fire exits are for emergency use only:  Fire doors must remain closed at all times except in case of an emergency.  The front door is the only entrance to the building.  All other doors are alarmed.                                                                                                                                     _______

 

  1. Keep your room clean:  There will be periodic room inspections to ensure that rooms meet basic health and sanitary fitness.  Dirt and garbage attract insects and create an unsafe environment for all residents.  You will receive a 24-hour notice prior to any inspections.                             _______

 

  1. Do not remove furniture from your room:  These are furnished rooms and the furniture must remain in the room after your tenancy has ended.  You will be held responsible for any furniture that is removed from your room during or after your tenancy.  If you would like to move any furniture into the house, you must first have permission from Worcester Community Housing Resources.                                                                                                                                    _______

 

  1. No cooking is allowed in your room:  Cooking must be confined to the kitchen only.  Hot plates, crock pots, microwave ovens, toaster ovens, electric skillets or any other cooking devices which heat or cook food are not allowed in the rooms.  This is a fire law.  Anyone found in possession of any cooking device in his or her room will have 24 hours to dispose of the devise or it will be confiscated and stored in the management office until your tenancy terminates.                                  _______

 

  1. Electric heaters are not allowed:  They are a fire hazard and anyone found in possession of an electric heater will have 24 hours to discard it or it will be confiscated and stored in the management office until your tenancy terminates.  If you room seems exceptionally or unusually cold, please report this to management.                                                                                                      _______

 

 

 


 

  1. Take out the trash:  Everyone is expected to help keep the house looking and smelling clean.  Please discard trash appropriately and empty the trash when it is full.  Trash container is located in the rear yard.                                                                                                                     _______

 

  1. Clean the kitchen after use:  The kitchen is equipped with a sponge and cleanser for your convenience.  Dishes, pots and pans, countertops and the stove must be cleaned immediately after use.  It only takes a minute to wipe down the stove, counter or table so they are clean for the next person.  Items left in the kitchen sink will be discarded after 24 hours.                            _______

 

 

  1. Clean the bathroom after use:  Take a minute to clean the sink, toilet and/or tub.  Items left in the bathroom will be discarded after 24 hours.                                                                    _______

 

  1. Clean the laundry room after use: Take a minute to clean the washer, dryer or counter.  Hours of operation are 8AM to 10 PM.  Please use the laundry room only on the appropriate days as follows:  1st floor Monday and Thursday, 2nd floor Tuesday and Friday, 3rd floor Wednesday and Saturday, Open to all on Sunday.                                                                                                 _______

 

  1. Use the bathroom on the floor that you reside on only.  If that bathroom is occupied, use the next nearest bathroom.                                                                                                  _______

 

  1. Attendance at house meetings are mandatory:  You are required to attend scheduled meetings.  These meetings allow residents to discuss problems and address concerns.                    _______

 

  1. No Pets allowed:  Caged birds and fish may be allowed with prior permission from WCHR.                                                                                                                                    _______

 

  1. No firearms/weapons are allowed in the building:  Anyone found in possession of firearms or weapons will be subject to immediate eviction and police intervention.                            _______


 

 

  1. No alcohol or drug use allowed:  Alcohol consumption and/or drug use is strictly forbidden on the premises.  Drunken or disorderly behavior will not be tolerated.  The sale or use of illegal drugs will result in immediate eviction proceedings and police intervention.                                     _______

 

  1. No Overnight guests allowed:  The house cannot accommodate any more persons than the residents who are already living in the house.  Guests are not allowed during the hours of 10:00 PM and 8:00 AM.                                                                                                      _______

 

  1. You are responsible for the actions of your guests:  Anyone whom you allow into the building is your guest.  Only one guest is allowed in your room at a time unless they are immediate family.  Do not open the door or allow in, any persons not visiting you.  You are responsible to ensure that your guest respects the peace and privacy of others.  You are solely responsible for any damages resulting from the actions of your guests and payment for those damages.   Tenants must walk guests out of the building when leaving.                                                                                                   _______

 

  1. Be considerate of other tenants:   Noise volume from TV’s, radios, stereos, and voices must be kept low at all times so as not to disturb others.  Noise volume must not be heard during the hours of 10 PM and 8 AM.                                                                                                        _______

 

  1. Common areas may have security cameras:  Please be aware that common areas may be equipped with security cameras.  Cameras are used maintain security of the building.  Common areas with cameras may be recorded from time to time.                                                          _______

 

 

 

 

 

 

I have read and understand the above rules.  I agree to respect and abide by these rules while I am a tenant.  I understand that if I violate any of these rules, I will be subject to immediate eviction proceedings.

 

 

Tenant Signature                                                                     Date

 

 

Property Manager Signature                                                  Date

 

 


 

 

 

 

Please read thoroughly before signing this application

 

 

Have you, recently or in the past:

 

Filed Bankruptcy:_________________________________________________________
Been Arrested:___________________________________________________________

Been Evicted:____________________________________________________________

Refused to Pay Rent:_______________________________________________________

Have Criminal Record:_____________________________________________________

Been arrested or convicted of a drug related crime or violent crime within the past two years:___________________________________________________________________

If you answered yes to any of the above questions, please explain:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

I hereby consent and authorize any representative of Worcester Community Housing Resources to obtain, verify, exchange information on any reports concerning me as are maintained by, but not limited to: City, County, State, Federal Law Enforcement Agencies, Credit Reporting Agencies, Present/Past Employers and Landlords and Housing Assistance Agencies.  I understand that any information obtained may be considered by Worcester Community Housing Resources in their sole discretion, as a factor in the decision they make, with respect to the apartment for which I/We are applying.

 

I herby release and hold harmless: Agents, Owners and affiliates of, but not limited to: their Officers, Directors, Employees, Law Enforcement Agencies, Credit Reporting Agencies, Past/Present Employers and Landlords and Housing Assistance Agencies that shall provide information to Worcester Community Housing Resources.

 

I hereby certify that the information contained in this rental application is accurate, full and complete.  Any discrepancy or lack of information will result in the immediate rejection of this application.  I/We understand that this is an application for an apartment and does not constitute a Rental Agreement in whole or part.

 

 

 

Applicant’s Signature                                                          Date