APPLICATION COVER SHEET Thank you for applying with us. We have a waiting list for all of our units and only completed applications are placed on the waiting list. In order to swiftly process your application, we will need the following items: 1. Fully completed application. If a question doesn’t apply to you draw a line through it or write NA across it. Do not leave anything blank! 2. Credit check fee paid $8 per person or $10 for married couple 3. Copies of ALL Social Security Cards for all family members. 4. Age Verification Documents: drivers license, birth certifications or social security benefit letter 4. Proof of income-We cannot accept households with no income. a. 4 paycheck stubs, b. TANF or TEA statement from DHS, c. SS and or SSI benefits letter. d. Unemployment benefit letter e. Last year tax return with w-2/s f. Proof of Child Support or Alimony g. Divorce Decree 5. Last year’s tax return for student status if you are a college student and under the age of 24. (Proof you are independent of parents) Please note that if you do not return these needed items your application cannot be processed for housing. If you have any questions, or need assistance in filling out your application, we would be happy to help. Thank you. Management This institution is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected]. Revised 04/2014 Page 1 of 15 515-2010 Rental Application for : ______________________________________________ Do Not Mark In This Space (Project Name) Date Rec’d _____/_____/_____ Time: _____________________ The information collected below will be used to determine if you qualify as a tenant. It will not be disclosed without your consent except to your employer(s) for verification of income and employment and to financial institutions for verification of assets, and as required and permitted by law. You do not have to provide the information, but if you do not your application may be delayed or rejected. Please Print Clearly Applicant’s Name: ____________________________________________ SSN: __________________________ Mailing Address: _________________________ State: _____ Zip: _____________ City: ___________ Number of years at current address: ___________ Phone: ________________________ Name of Employer: _____________________________ Self Employed: Yes ( Business Phone: _______________________________ Type of Business: _____________ ) No ( ) Position/Title: _______________ Co-Applicant’s Name: _________________________________________ SSN: __________________________ Mailing Address: _________________________ State: _____ Zip: _____________ City: ___________ Number of years at current address: ___________ Phone: ________________________ Name of Employer: _____________________________ Self Employed: Yes ( Business Phone: _______________________________ Type of Business: _____________ ) No ( ) Position/Title: _______________ Household Composition List all persons who will reside in the apartment including all members who live there on a part time basis Member Number Full Name (as it appears on Social Security Card) Relationship to Head Marital Status: M - Married S -Single L - Legal Separation Birth Date Age Social Security Number Full Time Student Y-Yes N-No Head 2 3 4 5 6 7 8 This institution is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected]. Revised 04/2014 Page 2 of 15 515-2010 Student Status 1. 2. 3. 4. Are ALL members of your household full-time students? Will ALL members of your household become full-time students during any 5 months of this year? Will ALL members of your household be full-time students during any 5 months of next year? Is ANY ADULT member of your household a part or full-time student of higher education? Yes ( Yes ( Yes ( Yes ( ) ) ) ) No ( No ( No ( No ( ) ) ) ) If yes, who is enrolled? _________________________ Which school are they enrolled in? _______________________ How do they pay for their education? ___________________ What is the cost of tuition per semester?______________ 5. Does ANY ADULT member of your household intend to become a student within the next 12 months? Yes ( ) No ( If yes, who will be enrolling in school? _____________________________________________________ If yes, will they be enrolling as a full-time or part-time student? ________________________________ 6. Do you anticipate any additions to the household within the next 12 months? Yes ( ) No ( If yes, explain: ________________________________________________________________________ 7. Does anyone live with you that is not listed above? Yes ( ) No ( If yes, explain: ________________________________________________________________________ 8. Are you or any member of your household currently using an illegal controlled substance or have been convicted of doing so? Yes ( ) No ( If yes, explain: ________________________________________________________________________ 9. Is ANY household member subject to a lifetime sex offender registration requirement in any state? Yes ( ) No ( 10. In what states has each household member resided? (Please list all states for every household member.) ____________________________________________________________________________________ 11. Have you or any member of your household been convicted of a felony? Yes ( ) No ( If yes, explain: ________________________________________________________________________ 12. Have you or any member of your household been evicted or refused housing? Yes ( ) No ( If yes, when _______________ and for what reason ________________ 13. Have you ever filed bankruptcy Yes ( ) No ( If yes, explain:_________________________________________________________________________ 14. Do you or anyone in your household require a caregiver? Yes ( ) No ( If yes, explain:_________________________________________________________________________ 15. Do you have child care expenses for children 12 or under? Yes ( ) No ( If yes, how much: ______________________________________________________________________ 16. Do you own any pets? Yes ( ) No ( If yes, describe: ________________________________________________________________________ Attention Handicapped / Disabled Applicants Applicants may be eligible for income adjustments if the tenant or co-tenant has a handicap or disability, as defined by federal law. Certain other adjustments to income may be applicable if a household member other than the tenant or co-tenant has a handicap or disability, as defined by federal law. Additional information will be required to verify eligibility. PLEASE CHECK HERE to request adjustments for a tenant or co-tenant who is disabled / handicapped. PLEASE CHECK HERE to request adjustments for another household member who is disabled/handicapped. PLEASE CHECK HERE TO REQUEST A WHEELCHAIR ACCESSABLE UNIT: Apartments with special modifications for accessibility to persons in wheelchairs or other mobility impairments may be available. Rent on the above apartments is determined by the applicant’s income. Handicap units are available and priority will be given to those who require special design features. All responsible requests for special accommodations will be reviewd by management and in all cases possible will be met. Arkansas State Relay Service provides a toll free 24-hour a day service for the hearing impaired. That phone number is 1-800-285-1131. White River Regional Housing Authority provides equal Housing Opportunities. Revised 04/2014 Page 3 of 15 515-2010 ) ) ) ) ) ) ) ) ) ) ) Monthly Annual Income List ALL sources on income as requested below. Do not leave any blanks. Write N/A if a section does not apply Source Applicant Co-Applicant Other Household Members 18 or Older Total Salary Overtime Fees Tips Bonuses Interest and/or Dividends Net Income from Business Net Rental Income Social Security SSI Pensions, Retirement Funds Unemployment Benefits Workers Compensation Disability Compensation Child Support Welfare Benefits Other Income Contributions Family/Group Food Stamps Alimony: Have an entitlement to receive alimony that is not currently being received? Are you currently going through the courts to collect? Yes ( ) No ( ) Yes ( ) No ( ) Child Support: Have an entitlement to receive alimony that is not currently being received? Are you currently going through the courts to collect? Yes ( ) No ( ) Yes ( ) No ( ) Total Gross Annual Income based on the monthly amounts listed above X 12 $____________________ Do you anticipate any changes in this income in the next 12 months? Yes ( ) No ( ) Is yes, Explain_________________________________________________________________________ Revised 04/2014 Page 4 of 15 515-2010 Assets Please request an additional form if your number of assets exceeds the spaces available on the page. Do not leave any blank spaces. Write N/A if a section does not apply. Checking Accounts No. No. No. Bank: Bank: Bank: Balance $ Balance $ Balance $ Bank: Bank: Bank: Balance $ Balance $ Balance $ Bank: Bank: Balance $ Balance $ Bank: Bank: Bank: Balance $ Balance $ Balance $ Bank: Bank: Bank: Balance $ Balance $ Balance $ Bank: Bank: Bank: Balance $ Balance $ Balance $ Bank: Bank: Balance $ Balance $ Bank: Bank: Bank: Balance $ Balance $ Balance $ Savings Accounts No. No. No. Trust Accounts No. No. Certificates of Deposit No. No. No. Name of Credit Union No. No. No. Savings Bonds No. No. No. Life Insurance Policy No. No. Mutual Funds No. No. No. Revised 04/2014 Page 5 of 15 515-2010 Stocks or Bonds Name: Name: Name: # Shares # Shares # Shares Dividend Paid $ Dividend Paid $ Dividend Paid $ Value$ Value$ Value$ Investment Property Appraised Value $ Do you own real estate property? Yes ( ) No ( ) If yes, list type of property: Location of property: Appraised or Market Value $ Mortgage or outstanding loan value $ Amount of annual insurance premium $ Most recent tax bill $ Do you have any other assets not listed above (excluding personal property)? Yes ( ) No ( ) If yes, please list: Have you disposed of any property in the last 2 years? Yes ( ) No ( ) If yes, list type of property: Market value when sold/disposed $ Amount disposed/sold for $ Date of transaction (mm/dd/yyyy) Have you disposed of any other assets in the last 2 years? (Example: given money to realatives or set up Irrevocable Trust Funds? Yes ( ) No ( ) If yes, describe the asset: Date of disposition (mm/dd/yyyy) Amount disposed How did you hear about these apartments? Driving by Site Road Signs Web Site Residents Newspaper? Name of Newspaper____________________________________________________ Radio? Name of Station_______________________________________________________ Other? Explain:__________________________________________________________________ Revised 04/2014 Page 6 of 15 515-2010 Reference Information Current Landlord Name: Address: Home Phone: Business Phone: How Long? Previous Landlord Name: Address: Home Phone: Business Phone: How Long? Personal Reference #1 Name: Address: Relationship: Phone # Personal Reference #2 Name: Address: Relationship: Phone # In case of emergency notify: Name: Address: Relationship: Phone # Vehicle Information List any cars, trucks, or other vehicles owned. Parking will be provided for each vehicle. Arrangements with Manager will be necessary for more than one vehicle. Type of Vehicle Year/Make Type of Vehicle Year/Make Revised 04/2014 License Plate # Color License Plate # Color Page 7 of 15 515-2010 Certification/Consent I/we hereby certify that I/we do /will not maintain a separate subsidized rental unit in another location. I/we further certify that this will be my/our permanent residence. I/we understand I/we must pay a security deposit for this apartment prior to occupancy. I /we understand that my/our eligibility for housing will be based on applicable income limits and by management's selection criteria. I/we certify that all information in this application is true to the best of my/our knowledge and I/we understand that false statements or information are punishable by law and will lead to cancellation of this application or termination of tenancy after occupancy. All adult applicants, 18 or older, must sign this application. I/we consent to the disclosure of income and financial information from my/our employer and financial references for purposes of income e and asset verification related to my/our application for tenancy. ________________________________________________________________________ Signature Date ________________________________________________________________________ Signature Date ________________________________________________________________________ Signature Date _______________________________________________________________________ Signature Date “The information regarding race, ethnicity, and sex designation solicited on this application is requested in order to assure the Federal Government, acting through the Rural Housing Service that the Federal laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age and disability are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race ethnicity, and sex of individual applicants on the basis of visual observation or surname. Ethnicity: ( ) Hispanic or Latino ( ) Not Hispanic or Latino Gender ( ) Male ( ) Female Race (Mark one or More) ( ) 1. American Indian/Alaska Native ( ) 2. Asian ( ) 3. Black or African American ( ) 4. Native Hawaiian or Other Pacific Islander ( ) 5. White Revised 04/2014 Page 8 of 15 515-2010 APPLICANT/TENANT AUTHORIZATION FOR RELEASE OF INFORMATION WHITE RIVER REGIONAL HOUSING AUTHORITY I authorize the release of any information including documentation and other materials pertinent to eligibility for participation in any assisted housing program INFORMATION INQUIRIES ABOUT. CHILD CARE EXPENSES CITIZENSHIP CREDIT HISTORY CRIMINAL ACTIVITY FAMILY COMPOSITION EMPLOYMENT, INCOME PENSION, & ASSETS FEDERAL, STATE, TRIBAL OR LOCAL BENEFITS HANDICAPPED ASSISTANCE EXPENSES IDENTITY AND MARITAL STATUS MEDICAL EXPENSE SOCIAL SECURITY NUMBERS AND BIRTH DATES RESIDENCES AND RENTAL HISTORY INDIVIDUALS OR ORGANIZATIONS THAT MAY RELEASE INFORMATION: BANKS & OTHER FINANCIAL INSTITUTIONS COURTS LAW ENFORCEMENT AGENCIES CREDIT BUREAUS EMPLOYERS, PAST AND PRESENT LANDLORDS PENSIONS AND/OR ANNUITIES SCHOOLSaANDaCOLLEGES US DEPARTMENT OF VETERANS AFFAIRS US DEPARTMENT OF IMMIGRATION & NATURALIZATION US SOCIAL SECURITY ADMINISTRATION UTILITY COMPANIES WELFARE AGENCIES PROVIDERS OF ALIMONY CHILD CARE CREDIT HANDICAPPED ASSISTANCE MEDICAL CARE CHILD SUPPORT I agree that photocopies of this authorization may be used for the purpose stated above. If I do not sign this authorization, I also understand that my housing assistance may be denied or terminated. Signature Date Social Security No. Signature Date Social Security No. I certify that the above-named individual has read this document fully or that I have read it to him/her and I have explained its contents and answered any questions to the best of my ability and that he/she understood the significance of this document at the time of signing. Housing Authority Representative Revised 04/2014 Page 9 of 15 Date 515-2010 WHITE RIVER REGIONAL HOUSING AUTHORITY TENANT SELECTION POLICY for Rural Development 515/Tax Credit Properties The White River Regional Housing Authority (referred to as the Agent) shall use this tenant selection policy for all RD 515/Tax Credit properties under its management. The policy of the Agent is one of equal opportunity and non-discrimination in compliance with all Civil Rights legislation (1964,1968,1988) Section 504 of the Rehabilitation Act of 1973 (if applicable) and Affirmative Fair Housing Marketing requirements as set forth individually for each property. No applicant will be denied on the basis of race, color, religion, sex, handicap or disability, familial status, or national origin. 1. Applications must be completed in full. Only completed applications will be processed. Incomplete applications will be returned for completion, therefore, delaying the possible application approval and movein of an applicant. Applicants with zero income will not be considered for occupancy. Applicants must demonstrate the ability to pay rent, utilities, and reasonable living expenses. 2. Maximum household size allowed is two (2) people per bedroom plus an additional person per 50 square feet of living space (living space excludes closets, stairways, kitchen, dining room, hallways and bathrooms). Occupancy Guidelines are as follows: 1 bedroom apartment = 1 to 2 persons 2 bedroom apartment = 2 to 4 persons 3 bedroom apartment = 3 to 6 persons 4 Bedroom apartment = 7 to 10 persons Management retains the authority to grant exceptions to the policy to allow an under-housed or overhoused situation, when a unit meeting the occupancy guidelines is not available. Tenants will be required to vacate when an eligible applicant is on the waiting list or when an appropriate sized unit becomes available with a thirty (30) day written notice. It will be the tenant’s financial responsibility when transferring from a unit to bring the vacated apartment to “rental condition.” This includes all cleaning, painting, carpet shampooing and anything in excess of normal wear and tear. In the event the property does not have the appropriate sized unit to make a tenant eligible, the tenant will be required to vacate at the end of the term of their initial lease, with a thirty (30) day written notice. If the initial lease term has expired, the tenant will be required to vacate with a thirty (30) day written notice. 3. For rental units specially designed for persons with disabilities, an applicant/tenant who does not have a person with a disability in the household are permitted to occupy the rental unit until management issues a thirty (30) day notice that a priority applicant is on the waiting list at which time the ineligible tenant must move to another suitably sized vacant unit. It will be the tenant’s financial responsibility when transferring from a unit to bring the vacated apartment to “rental condition.” This includes all cleaning, painting, carpet shampooing and anything in excess of normal wear and tear. Revised 04/2014 Page 10 of 15 515-2010 4. Applicants will be required to provide past landlord history for a minimum of three (3) years. Applicant must provide full names of landlords, addresses, telephone numbers, and dates of occupancy on the Rental Application or the application will be considered incomplete. a. If applicant’s past residency has been as a homeowner, Management reserves the right to request a credit reference from the mortgage holder of the property. 5. CREDIT HISTORY – A national credit-reporting agency will process the credit application. 6. CRIMINAL BACKGROUND – A criminal background check will be run on each individual 18 years of age or older who will be residing in the apartment. 7. Applicants will be placed on the waiting list according to the date and time completed applications are received. Applicants who have a need for “special design features” of accessible units will be given first priority for units designed for persons with disabilities. 8. Only the applicant may request information on their current status on the waiting list by writing, calling or appearing in person at the site office. To protect the privacy of all prospective tenants, the waiting list will not be shown to any prospective tenant. 9. Applicant must fill out all forms. Each household member must sign his/her own signature as requested on each form. Forged signatures or someone else signing for the specified household member may be grounds for ineligibility of an application or eviction of a tenant. 10. All adult household members must be present when Management requests a personal interview and must show positive identification when requested. Birth certificate or other proof of parental relationship or guardianship may be requested in order to verify eligibility for deductions for a minor child. 11. All college students will be required to furnish proof whether they are a full-time (12 hours or more) student. All students must meet the following requirements in order to be eligible: a. Must be of legal age or otherwise legally able to enter into a binding contract under State Law. b. Must not be claimed as a dependent on parents’ or legal guardian’s tax return. c. The applicant must provide a notarized written statement when applicable, stating financial assistance is being provided by parents, legal guardians or others. Any such assistance will be considered as part of annual income. d. Student status has several exceptions. Contact a Management Representative to discuss your specific situation. 12. Applicants will be required to furnish verification of persons with disability status if they wish to deduct expenses related to their disability from their income and/or if they wish to be considered eligible for occupancy in apartments designated as Elderly housing. Management’s policy for verifying an individual’s disability is as follows: a. The Rental Application requires the applicant(s) to indicate whether they or anyone in the family would benefit from special features for persons with disabilities. b. If yes, the applicant is advised that Management requires a document verifying disability such as a Social Security Statement or a statement from an independent third person, such as a physician, clergyman, or other person who has knowledge of the disability. Revised 04/2014 Page 11 of 15 515-2010 13. Any person wishing to join an existing household must make separate application and must be eligible for housing in this property as a separate household. 14. The Head of Household and the Co-Tenant (if any) must be legally of age and able to enter into a Lease Agreement. 15. An applicant will be offered an apartment of appropriate size and type. If more than one such apartment is vacant, the applicant will be given a choice. If the applicant turns down the vacancy offered, the applicant will be placed at the bottom of the waiting list. The new eligibility date is the date the applicant turned down the first offer. 16. All applicants must require rental assistance. This is a 100% rental assistance program. Rental assistance will be assigned in accordance with Exhibit 8-2 of HB-2-3560. 17. Applicants may be ineligible if: a. Application is incomplete. b. Family composition does not conform to units available on property. c. Household income exceeds published income limits for the IRS Section 42 program or USDA Rural Development, whichever is the most restrictive. All applicants must be eligible for rental assistance. d. Applicant provided false information necessary in the determination of eligibility. e. Past performance in meeting financial obligations, including past rent and credit history, and past performance shows inability to fulfill a one (1) year lease or a poor history of job stability (minimum six (6) months). f. Applicant has no present guaranteed income. g. Applicant has a record of disturbance of neighbors, destruction of property, living or housekeeping habits which adversely affect the health, safety, or welfare of other tenants. h. Applicant has a history of criminal activity involving crimes of physical violence to persons or property or other criminal acts which adversely affect the health, safety, or welfare of themselves or other tenants or the viability of the property. This includes but is not limited to the possession, sale or use of illegal substances. i. Applicant is presently on parole or probation for any criminal, civil, domestic action, etc. This is also valid for up to 24 months from the time parole or probation expires. 18. Management will make reasonable accommodations and allow reasonable modifications for persons with disabilities, under the Federal Law. In order to provide optimum communications with applicants, tenants and members of the public that have sight or hearing impairments, the Management Agent will utilize the state relay service operated by “Arkansas Relay Service.” Assistance will be given for completing the application. The Management Agent provides handicapped accessible interview rooms. Any applicant/tenant who thinks his/her rights have been violated under the Fair Housing and Equal Opportunity laws should contact the HUD Regional Office, Attn.: Fair Housing and Equal Opportunity, PO Box 2778, Little Rock, AR 72203, or call toll free 1-800-424-8590. *** All approved applications must be updated every six (6) months to remain on the active waiting list. *** Revised 04/2014 Page 12 of 15 515-2010 Rural Housing and Community Programs Things You Should Know About USDA Rural Rental Housing Don’t risk losing your chances for federally assisted housing by providing false, incomplete, or inaccurate information on your application or recertification Penalties for Committing Fraud You must provide information about your household status and income when you apply for assisted housing in apartments financed by the U.S. Department of Agriculture (USDA). USDA places a high priority on preventing fraud. If you deliberately omit information or give false information to the management company on your application or recertification forms, you may be: Evicted from your apartment; Required to repay all the extra rental assistance you received based on faulty information; Fined; Put in prison and/or barred from receiving future assistance. All Household Members. List the names of all the people, including adults and children, who will actually live with you in the apartment, whether or not they are related to you. Ask for Help if You Need It If you are having problems understanding any part of the application, let the landlord know and ask for help with any questions you may have. The landlord is trained to help you with the application process. Before You Sign the Application Make sure that you read the entire application and understand everything it says; Check it carefully to ensure that all the questions have been answered completely and accurately; Don’t sign it unless you are sure that there aren’t any errors or missing information. Your State and local governments also may have laws that allow them to impose other penalties for fraud in addition to the ones listed here. How To Complete Your Application By signing the application and certification forms, you are stating that they are complete to the best of your knowledge and belief. Signing a form when you know it contains misinformation is considered fraud. When you meet with the landlord to complete your application, you must provide information about: All Household Income. List all sources of money that you receive. If any other adults will be living with you in the apartment, you must also list all of their income. Sources of money include: –Wages, unemployment and disability compensation, welfare payments, alimony, Social Security benefits, pensions, etc.; –Any money you receive on behalf of your children, such as child support, children’s Social Security, etc.; –Income from assets such as interest from a savings account, credit union, certificate of deposit, stock dividends, etc.; –Any income you expect to receive, such as a pay raise or bonus. All Household Assets. List all assets that you have. If any other adults will be living with you, you must also list all of their assets. Assets include: Tenant Recertification Residents in USDA-financed assisted housing must provide updated information to the management company at least once a year. Ask your landlord when you must recertify your income. You must immediately report: –Bank accounts, savings bonds, certificates of deposit, stocks, real estate, etc.; –Any business or asset you sold in the last 2 years for less than its full value, such as selling your home to your children. Revised 04/2014 The management company will verify your information. USDA may conduct computer matches with other Federal, State or private agencies to verify that the income you reported is correct; Ask for a copy of your signed application and keep a copy of it for your records. Any changes in income of $100 or more per month; Any changes in the number of household members. For your annual recertification, you must report: Page 13 of 15 All income changes, such as increases in pay or benefits, job change or job loss, loss of benefits, etc., for any adult household member; 515-2010 Any household member who has moved in or out; All assets that you or your adult housemates own, or any assets that were sold in the last 2 years for less than their full value. Avoid Fraud, Report Abuse When a Grievance Is Legitimate Prevent fraudulent schemes through these steps: The landlord must determine if a grievance is within the established rules for the program. For example, “I want to file a complaint because the manager doesn’t speak to me” is not a legitimate complaint. However, “I want to file a complaint because the manager isn’t maintaining the property according to USDA guidelines” is a legitimate complaint. Below are examples of cases in which tenants may and may not file a complaint. Don’t pay any money to file your application; Don’t pay any money to move up on the waiting list; Don’t pay for anything not covered by your lease; Get receipts for any money you do pay; Get a written explanation for any money you are required to pay besides rent, such as maintenance charges. Report Abuse: If you know anyone who has falsified an application, or who tries to persuade you to make false statements, report him or her to the manager. If you cannot report to your manager, call your local or state USDA office at 1 (800) 670-6553, or write: USDA, STOP 0782, 1400 Independence Ave., SW, Washington, DC 20250. If You Disagree With a Decision Tenants may file a grievance in writing with the complex owner in response to the owner’s actions, or failure to act, that result in a denial, significant reduction, or termination of benefits. Grievances may also be filed when a tenant disputes the owner’s notice of proposed adverse action. Notice of Adverse Action The complex owner must notify tenants in writing about any proposed actions that may have adverse consequences, such as denial of occupancy and changes in the occupancy rules or lease. The written notice must give specific reasons for the proposed action, and must also advise tenants of the “right to respond to the notice within 10 calendar days after the date of the notice” and of “the right to a hearing.” Housing complexes in areas with a concentration of non-English-speaking people must send notices in English and in the majority nonEnglish language. A complaint may not be filed with the owner/management if: A complaint may be filed with the owner/management if: USDA has authorized a proposed rent change. There is a modification of the lease, or changes in the rules or rent that are not authorized by USDA. A tenant believes that he/she The owner or management fails has been discriminated against to maintain the property in a because of race, color, religion, decent, safe, and sanitary mannational origin, sex, age, familial ner. status, or disability. Discrimination complaints should be filed with USDA and/or the Department of U.S. Housing and Urban Development (HUD), not with the owner/management. The complex has formed a ten- The owner violates a lease proant’s association and all parties vision or occupancy rule. have agreed to use the association to settle grievances. USDA has required a change in A tenant is denied admission to the rules and proper notices the complex. have been given. The tenant is in violation of the lease and the result is termination of tenancy. There are disputes between tenants that do not involve the owner/management. Tenants are displaced or other adverse effects occur as a result of loan prepayment. PA 1998 December 2008 Grievance Process Overview USDA believes that the best way to resolve grievances is through an informal meeting between tenants and the landlord or owner. Once the owner learns about a tenant grievance, the process should begin with an informal meeting between the two parties. Owners must offer to meet with tenants to discuss the grievance within 10 calendar days of receipt of the complaint. USDA encourages owners and tenants to try to reach a mutually satisfactory resolution to the problem at the meeting. Revised 04/2014 If the grievance is not resolved, the tenant must request a hearing within 10 days of receipt of the meeting findings. The parties will then select a hearing panel or hearing officer to govern the hearing. All parties are notified of the decision 10 days after the hearing. The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or a part of an individual's income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer. Page 14 of 15 515-2010 Para informacion en espanol, visite www.ftc.gov/credit o escribe a la FTC Consumer Response Center, Room 130-A 600 Pennsylvania Ave. N.W., Washington, DC 20580. A Summary of Your Rights Under the Fair Credit Reporting Act The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.ftc.gov/credit or write to: Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Ave. N.W., Washington, DC 20580. • You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address and phone number of the agency that provided the information. • You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if: • A person has taken adverse action against you because of information in your credit report; • You are the victim of identify theft and place a fraud alert in your file; • Your file contains inaccurate information as a result of fraud; • You are on public assistance; • You are unemployed but expect to apply for employment within 60 days. In addition, by September 2005 all consumers will be entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.ftc.gov/credit for additional information. • You have the right to ask for a credit score. Credit scores are numerical summaries of your credit worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender. • You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.ftc.gov/credit for an explanation of dispute procedures. • Consumer reporting agencies must correct or delete inaccurate, incomplete or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate. • Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old. landlord, or other business. The FCRA specifies those with a valid need for access. • You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.ftc.gov/credit. • You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567-8688. • You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court. • Identity theft victims and active duty military personnel have additional rights. For more information, visit www.ftc.gov/credit. States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. Federal enforcers are: TYPE OF BUSINESS: Consumer reporting agencies, creditors and others not listed below National banks, federal branches/agencies of foreign banks (word "National" or initials "N.A." appear in or after bank's name) Federal Reserve System member banks (except national banks and federal branches/agencies of foreign banks) Savings associations and federally chartered savings banks (word "Federal" or initials "F.S.B." appear in federal institution's name) Federal credit unions (words "Federal Credit Union" appear in institution's name) State-chartered banks that are not members of the Federal Reserve System Air, surface, or rail common carriers regulated by former Civil Aeronautics Board or Interstate Commerce Commission Activities subject to the Packers and Stockyards Act of 1921 • Access to your file is limited. A consumer reporting agency may Revised 04/2014 Page 15 of 15 provide information about you only to people with a valid need usually to consider an application with a creditor, insurer, employer, CONTACT: Federal Trade Commission: Consumer Response Center FCRA Washington, DC 20580 1-877-382-4357 Office of the Comptroller of the Currency Compliance Management Mail Stop 6-6 Washington, DC 20219 1-800-613-6743 Federal Reserve Board Division of Consumer & Community Affairs Washington, DC 20551 202-452-3693 Office of Thrift Supervision Consumer Complaints Washington, DC 20552 800-842-6929 National Credit Union Administration 1775 Duke Street Alexandria, VA 22314 703-519-4600 Federal Deposit Insurance Corporation Consumer Response Center 2345 Grand Avenue, Suite 100 Kansas City, Missouri 641082638 1-877-275-3342 Department of Transportation Office of Financial Management Washington, DC 20590 202-366-1306 Department of Agriculture Office of Deputy Administrator GIPSA Washington, DC 20250 202-720-7051 515-2010
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