E. P. Management Corp.Application for Housing
Whittier, Arbor Garden, Monarch and Victoria Place Apartments
4 Carmichael St. Unit 200, Essex Jct., VT 05452 (802) 878-7000 Fax 802-878-7006
E.P. Management Corp. is an equal opportunity housing provider and does not discriminate against any applicant or tenant on the basis of race, color, creed, national origin, sex, sexual orientation, gender identity or gender-related characteristics, children, familial status, receipt of public assistance, age, marital status, or based upon handicap or disability.
In addition, E.P. Management Corp. has a legal obligation to provide a “reasonable accommodation” to applicants and tenants if they or any family member has a disability or handicap. If you or a family member has a disability or handicap and think that you may need or want a reasonable accommodation, you may request it at any time in the application process or after admission. For example, if you need help completing this application because of a disability, please let us know. A Notice with more information about your right to request a reasonable accommodation will be provided to you during the application process and is posted in all buildings managed by E.P. Management Corp
InstructionsPlease type or print in ink the information requested on this form. If you need more space, please attach separate sheets of paper. Please answer carefully and completely since this information will be used to determine your eligibility. If you need assistance in completing this application due to a disability, please ask management for assistance.
Building Preference ______Apt. size 1BR _____2BR _____ 3BR ____
Desired Date of Occupancy: ______Smoke? Yes ______No______Pets? Yes_____ No_____
If yes is the pet a service or support animal necessary to accommodate a disability? Yes ______No ______
- FAMILY COMPOSITION: All household members over the age of 18 must sign this application. Complete the following information for each member of your family (including yourself) who will occupy the apartment.
Name / Social Security #
or Alien Reg. # / Date of Birth / Sex / Relationship
to Applicant / *FT
Student?
A / Applicant
B / Spouse
C / Other
D / Other
*Are there any full-time students in the household or will there be in the next 12 months? Yes ____ No ____
The IRS 8823 Guide definition of student status states:
Student•“An individual who during each of five calendar months during the calendar year in which the taxable year of the taxpayer begins-–is a full-time student at an educational organization described in section170(b)(1)(A)(iii)); or–is pursuing a full-time course of institutional on-farm training under the supervision of an accredited agent of an educational organization described in section 170(b)(1)(A)(ii) or of a state or political subdivision of a state.”IRC Sect 151(c)(4)
2.Do you anticipate any changes in your family composition?YesNo
If you answered yes, please explain: ______
The following information is requested by E.P. Management Corp. in order to assure the Federal Government, acting through the Vermont State Housing Authority, Vermont Housing Finance Agency, USDA, Rural Development, and U.S. Department of Housing and Urban Development, that Federal laws prohibiting discrimination against applicants on the basis of race, color, national origin, sex, sexual orientation, familial status, age, handicap or because the applicant is a recipient of public assistance. 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/national origin and sex of the individual applicants on the basis of visual observation or surname.
- Is the head of household or the spouse a member of a legal minority group?
Yes_____No_____ if you answered yes, please specify:
White / Black / American Indian / Asian / Hispanic / Non-Hispanic / OtherPRESENT HOUSING STATUS
- What is your present address? ______
City/State ______
- What is your telephone number? (H)______(C) ______(W) ______
Email address: ______
- How long have you lived at your present address? ______
- Do you:(Check those which apply) Own your own home? Yes ____ No ____ / Rent ___ Yes ___ No____
Live with others? Yes ___ No ___Who? ______Tel # ______
8. If you rent, who is your present landlord?______Tel. # ______
Address: ______
9. If you have moved within the past five years, what were your previous addresses:
Addresses / 1. / 2.City, State
Landlord
Landlord’s Address
“ City, State
Landlord's Phone #
Dates of Residence
10.Are you being forced to move from your home?Yes ______No ______
If you answered yes, please explain: ______
INCOME and ASSETS
11.Does anyone listed in question #1 have paid employment? Yes ______No ______
If you answered yes, please specify:
Occupation / Employer: Name and Address / Employer Tel. No.Applicant
Spouse
Other
12.What is the exact amount PER MONTH of your:
Applicant / Spouse / OtherA / Social Security Income / $ / $ / $
C / Salary or Wage (gross amount) / $ / $ / $
D / Self Employment Income / $ / $ / $
E / Pension or Annuity Income / $ / $ / $
F / General Assistance / $ / $ / $
H / Child Support Income / $ / $ / $
I / Other (specify: Housing Assistance, Unemployment, etc. / $ / $ / $
13.Do you own real estate?YesNo
If you answered yes, please specify and submit verification.
Address / Current Market Value / Remaining Mortgage Amount$ / $
14.Does anyone in question #1 have a checking or savings account or any certificates of deposit? Yes ______No ______If you answered yes, please specify.
Family Member / Type of Account / Account No. / Rate of Interest / Balance / Bank% / $
% / $
% / $
15.Does anyone in question #1 have an Individual Retirement Account (IRA), 401k, pension or annuity? Yes ______No ______If you answered yes, please specify.
Family Member / Type of Account / Account No. / Rate of Interest / Balance / Bank% / $
% / $
% / $
16.Does anyone listed in question #1 own any stocks or bonds?Yes ______No ______
If you answered yes, please specify.
Stock / Current Market Value / Name of Company / Number of Shares / Share-holder / Dividend Paid / Per$ / $
05/13/19
- 1 -
Bonds / Value / Paying Company / Holder / Interest earned / Per$
Savings
Bonds / Value / Series # / Holder / Interest earned / Per
$
17.Does anyone listed in question #1 own a motor vehicle?Yes ______No ______
If yes, please specify.
Year/Make / Model/Color / State & Plate Number18.Does anyone in question #1 currently own any other assets, excluding furniture and the motor vehicle(s) used for your personal transportation? Yes ______No ______
If you answered yes, please specify.
Description of Asset / Year Purchased / Current Value$
19.Has anyone in question #1 disposed of, transferred, or otherwise given away assets for less than what they were worth during the past two years? Yes ______No ______
If you answered yes, please explain.
Description of Asset / Cash Value / Amount Received / Date Disposed$ / $
$ / $
20.Does anyone listed in question #1 expect any change in income or in assets during the next twelve (12) months? Yes _____ No _____ If you answered yes, please explain.
GENERAL INFORMATION
21.Have you or any member of your household ever been evicted or have eviction proceedings ever been commenced against you? Yes ______No ______If yes, please explain. ______
22.Are you or any member of your household a registered sex offender? Yes ____ No ____
If yes, please explain. ______
23.Are you a veteran of the armed forces of the United States?Yes ______No______
24.Has anyone listed in question #1 ever been convicted of a crime? Yes ______No ______
If you answered yes, please explain: ______
25.Does anyone in question #1 have any pending criminal charges? Yes____ No ____
If you answered yes, please explain: ______
26.Why do you want to move into this apartment building? (Please use an additional piece of paper if necessary) ______
Please give three (3) references (other than family).
Name / 1. / 2. / 3.Address
City, State, Zip
Telephone Number
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I understand that the information contained in this application form will be used to determine my eligibility for housing. I grant consent for management to make any and all inquiries to verify information with rental and credit screening services, and to contact previous and current landlords or other sources for credit and verification information which may be released to appropriate Federal, State or Local agencies.
I authorize management to obtain one or more "credit consumer reports" as defined in the Fair Credit Reporting Act, 15 U.S.C. Section 1681a(d), seeking information on my credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living.
Furthermore, I understand that providing any false or misleading information on this application will result in a denial or if learned after approval-this will be grounds for eviction. Therefore, I certify that all of the above information is true and complete to the best of my knowledge and belief.
Date:Applicant's Signature:
Driver’s License # ______State ______
Date:Applicant's Signature:
Driver’s License # ______State ______
Date:Applicant's Signature:
Driver’s License # ______State ______
For office use only:
Date Received______
Location Preferred______
Approved ______
Denied ______
Reason Denied______
Management Signature______Date ______
E. P. Management Corporation
GENERAL RELEASE
I hereby authorize E. P. Management Corporation and its staff to contact any, but not limited to, agencies, offices, employers, landlords, banks and other financial institutions, credit bureaus and law enforcement agencies to obtain any information or materials which it deems necessary to verify information supplied by me the applicant/tenant. This information will be used to determine my eligibility for a rental unit that E. P. Management Corporation manages.
I agree that photocopies of this authorization may be used for the purposes stated above.
______
Signature of Applicant Dated
______
Print Name
______
Mailing Address (including city, state & zip)
______
Signature of Co-ApplicantDated
______
Print Name
______
Mailing Address (including city, state & zip)
SUPPORT OFFICE: 1 Falcon Manor # 104, Williston, VT 05495 • 802-316-0888 • Fax 802-872-2706
BRANCH OFFICE: 10 Eagle Crest Drive # 129, Williston, VT 05495 • 802-878-0524 • Fax 802-878-4797
BRANCH OFFICE: 4 Carmichael Street # 200, Essex Jct, VT 05452 • 802-878-7000 • Fax 802-878-7006
BRANCH OFFICE: 110 Hawk’s Nest Suite 110, St Albans, VT 05478 • 802-527-9870 • Fax 802-527-9871
BRANCH OFFICE: 5 Victoria Lane Suite 1, St Albans, VT 05478 • 802-528-8345 • Fax 802-528-8433
BRANCH OFFICE: 142 Merchants Row, Suite 1 - Rutland, VT 05701 • 802-775-1100 • Fax 802-775-6360
CORPORATE OFFICE: 7 Tozer Road, Beverly, MA 01915 • 978-232-1126 • Fax 978-232-1195
E. P. MANAGEMENT CORPORATION
IMPORTANT NOTICE
RIGHTS OF TENANTS WITH A DISABILITY
A person with a disability is entitled to ask their housing provider for reasonable accommodations or reasonable modifications at any time during their tenancy. A reasonable accommodation is an accommodation in rules, policies, practices or procedures that will allow an individual with a disability an equal opportunity to use and enjoy their dwelling, including public and common use areas. A reasonable modification is a physical change or structural modification that will enable a tenant with a disability the full use and enjoyment of the dwelling unit.
Examples of reasonable accommodations
A tenant with a disability who has trouble walking can ask the housing provider for a reserved parking space close to their apartment, even if this is contrary to the landlord’s general parking policy.
A tenant whose disability requires an assistance animal (often referred to as service animals, assistance animals, support animals or therapy animals) can request a waiver of a landlord’s pet policies.
Examples of reasonable modifications
Installing a ramp or installing grab bars in bathrooms.
In general, a tenant in privately owned housing must pay for making reasonable structural modifications. In federally-subsidized housing, the housing provider may be required to pay for some modifications.
There is no limit on the number of reasonable accommodations or reasonable modifications that an individual with a disability can request. A housing provider must consider each request and agree to the request unless the proposed accommodation or modification would:
1. Fundamentally alter the nature of the housing being offered
2. Pose an undue financial or administrative burden to the housing provider
3. Present a direct threat to the health or safety of others or to property.
It is best to put your request for a reasonable accommodation or reasonable modification in writing and to keep a copy. To request a reasonable accommodation contact your property manager first.
You have a right to receive a response to your request in a timely manner. If you have any further questions about your eligibility for a reasonable accommodation or reasonable modification, or if you feel that your request has not been acted upon in a timely manner, please contact:
E.P. Management Corp. – Suzanne P. Martin(802) 878-7000
E.P. Management Corp. – Main Office1-800-272-4205
Vermont Center for Independent Living1-800-639-1522
Vermont Human Rights Commission(802) 828-2480/1-800-416-2010
Vermont Legal Aid1-800-889-2047
Fair Housing Project of the Champlain Valley
Office of Economic Opportunity(802) 864-3334/1-800-287-7971
E.P. MANAGEMENT CORPORATION
REASONABLE ACCOMMODATIONS HOUSING POLICY & PROCEDURE
POLICY: The E.P. Management Corporation complies with state and federal laws requiring housing providers to make reasonable accommodations or changes to either rule, procedures and housing units or properties, if such changes are necessary to enable a person with a disability to have equal access to and enjoyment of the unit, property, facility or program.
Reasonable accommodations will be made during the application process and during an individual’s participation in our housing; provided the accommodation does not present an undue financial or administrative burden on the Owner and the request is reasonable. Any accommodation or change must be necessary for the individual to have equal access and enjoyment of the housing and programs, not just be desirable.
E.P. Management will consider suggested accommodations from an individual and determine whether the request is reasonable from a financial and administrative point of view. If such accommodation is not reasonable, E.P. Management will work with the individual to provide an alternative accommodation that would meet their disability needs.
WHAT IS A DISABILITY: To be eligible to request a reasonable accommodation, the requester must verify that she is a person with a disability under the following ADA definition:
A physical or mental impairment that substantially limits one or more of the major life activities of an individual; the individual has record of such impairment; and the individual is regarded as having such an impairment.
DEFINITIONS: If you have a disability and you need…
A change in our rules, policies or practices that would make it easier for you to apply for or participate in our programs;
A change or repair in your unit or a special type of unit that would make it easier for you to enjoy your home;
A change or repair to some other part of the housing complex that would make it easier for you to live there and use the facilities or take part in programs on site; or
A change in the way we communicate with you or give you information,
You can ask for this kind of change, which is called REASONABLE ACCOMMODATION.
PROCEDURES: If you can show/demonstrate that you have a disability, if your request is reasonable and financially and administratively possible, we will try to make the changes or grant the accommodation you request.
If you need assistance in completing the REQUEST FOR A REASONABLE ACCOMMODATION form, staff will be happy to provide help to you.
We will review the request and give you an answer in 10 working days unless there is a problem getting all the information we need from third parties or unless you agree to a longer time. We will let you know if we need more information or verification from you or if we would like to talk to you about other ways to meet your needs.
If we turn down or deny your request, we will explain the reasons for the denial and you can give us more information if you think that will help change our decision.
If you have questions regarding your rights as a disabled tenant, you may contact:
Vermont Center for Independent Living at 1-800-639-1522 (Voice and TTY) or 802-229-0501 (Voice and TTY);
Vermont Human Rights Commission at 1-800-416-2010 (Voice and TTY) or 802-828-2480 (Voice and TTY); or
Vermont Legal Aid at 1-800-889-2047.
E. P. Management Corporation
Tenant Selection Criteria
E. P. Management Corp. is an equal opportunity housing provider and does not discriminate against any applicant or tenant on the basis of race, color, creed, national origin, sex, sexual orientation, children, familial status, receipt of public assistance, age, marital status, or based upon handicap or disability.
APPLICATIONS
Applications are available at the above address or can be mailed to those who choose not to come to the office.
The owner reserves the right to suspend the acceptance of applications should the number of active applications on file exceed the number of vacancies projected to occur over the next 12 months.
Applicants that need assistance with the application due to a disability should contact Management for assistance.
ELIGIBILITY FOR ADMISSION
Applicants will be determined eligible if they meet the following requirements:
- For Market Units: Satisfy applicable income standards and submit a completed application.
- For Housing Credit Units: Satisfy the applicable income and occupancy standards and submit a
completed application.
TENANT SCREENING STANDARDS
Eligible applicants will be considered separately for Market Units and Housing Credit Units. Tenants will be selected from among the pool of eligible applicants who meet the following screening criteria.
a) Applicant must have a satisfactory credit. If the Applicant does not have a quantifiable credit score or no formal credit history as shown on a credit report, the Applicant must provide Owner/Landlord with positive credit references (for example, references from former landlords, utility companies and the like.) Owner/Landlord does not factor in unpaid/outstanding medical bills and deferred student loans when reviewing the Applicant’s credit report.
b) Applicant must demonstrate satisfactory past performance in meeting financial obligations, including but not limited to, rent payment and payment of utility bills.
c) Applicant must demonstrate the ability to meet current and projected financial obligations. The applicant’s projected rent and utility payments must be under 50% of the applicant’s gross income for the unit to be considered affordable.
d) Applicant must provide verifiable and positive landlord references (other than relative). The applicant may not have a history of lease violations, prior eviction(s), disturbance of neighbors, destruction of property, or housekeeping habits that may adversely affect the health, safety or welfare of other tenants.
e) Criminal history should read: Applicant’s criminal record will be reviewed. Applicant must not have a criminal record going back 5 years from the date of the application involving violent crimes, crimes involving drugs, fraud, crimes against children, sexual assault or any other crime that would adversely affect the health, safety and welfare of other tenants or inhibit the Applicant’s ability to live in the property. If jail time was served, the five year period shall commence at the time of release and/or the completion of the sentence, whichever date is later. In the event Applicant is denied based upon a negative criminal record, Applicant shall have 5 days to submit a written dispute to Owner regarding the accuracy or relevance of the criminal record. Owner may also consider any evidence that the applicant/household member(s) has successfully completed a satisfactory supervised drug rehabilitation program or the circumstances that Owner believes would pose a threat to the development no longer exist. Finally, Owner may factor in and consider the seriousness of the crime/offense; effect on the community; extent of participation by the household member; the effect of denial of admission on the household members not involved in the offense/offending action; the demand for housing by families who will adhere to lease responsibilities; and the extent to which the Applicant and household members have taken steps to prevent or mitigate future offenses or conduct. However in the end, the final decision to admit a household with a criminal record rests solely and totally within the Owner's discretion.