* Has anyone listed in the application previously rented/owned a home with Comprehensive Housing Division?
Yes
No
* Does anyone listed in the application have unpaid balances owed to Comprehensive Housing Division?
Yes
No
* have a current utility provider they are responsible to pay?
Yes
No
* Does anyone listed in the application have a Felony, Drug, or Act of Violence Conviction?
Yes
No
* Is any household member listed in the application subject to lifetime sex offender registration?
Yes
No
* Will anyone under age 18 listed within Household Information section live in the unit less than 50% of the next 12 months?
Yes
No
* Please provide their name(s) and explain:
* Does your family have any pets?
Yes
No
Please note: prior to acceptance, you will be required to complete a Pet Agreement Form .
* Has anyone listed in the application lived in another State?
Yes
No