Residential Long-Term Application

12-Month Lease Application

All adults 18 and older living in the home must be listed as co-applicants. A $35 non-refundable application fee is required after submission.

Primary Applicant

Person responsible for the lease.

Full Legal Name*

Date of Birth*

Driver's License #

Email Address*

Phone Number*

Desired Move-in Date*

Current Address

Street Address*

City*

State*

ZIP*

Previous Amount Paid for Rent (USD/month)*

Employment & Income

Employer Name

Job Title

Monthly Gross Income (USD)*

Time at Current Job

Required Document Uploads

All four uploads are required.

Pay Stub #1*

Pay Stub #2*

Driver's License — Front*

Driver's License — Back*

DCA Voucher

Do you have a DCA voucher?*

Co-Applicants / Adults 18+ Living in the Home

Any person 18 years or older who will live in the home must be listed as a co-applicant.

Background Questions

Have you ever filed for bankruptcy?*

Have you ever been convicted of a violent crime?*

Have you ever participated in gang-related activity?*

Application Fee: A non-refundable $35 application fee is required. Payment instructions will be sent to your email after submission. Your application will remain in Payment Pending status until the fee is received.

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