40B - Income Certification Rental Application

  • You have reached step 2 of the application process. You will be asked to upload proof of income, bank statements, and texes.

  • Right to Interpretation Document

  • For more information or reasonable accommodations for persons with disabilities, please contact us using the information provided on the property website or email that you received.

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  • Income Restricted Rental Application

    Please review carefully
  • Purpose of Application*
  • Format: (000) 000-0000.
  • Race & Ethnicity (Optional Disclosure) This response is for the race and ethnicity of the head of household only. There is no penalty for persons who do not complete this section of the application. This information will only be used in aggregate, for the purposes of reporting and analysis. Please check all that apply:
  • Do you have Housing Assistance? (Housing Voucher, Section 8, VASH, MRVP, HomeBase, etc.)*
  • Is your property located in Somerville?*

  • Somerville Properties Only

     

    If you have a housing voucher, you are not required to complete this application.  Instead, we will need your Housing Authority to provide us with the recertification paperwork that you submitted.

  • Income Certification of Tenant Eligibility - MPDU

     

    The Income Certification of Tenant Eligibility form must be completed and uploaded in the below field. 

    This form is fillable and can be digitally signed through the PDF. 

    This means you do not have to print it out.

     

  • MPDU Application: Click here to download the application

  • Rockville Application: Click here to download the application

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  • Each adult member of the household cannot currently own or have owned residential property within the last five (5) years. Please confirm you qualify.*

  • Social Security Card and Birth Certificate Upload - MPDU

     

     

    Please upload a Social Security card for all household members.

    Please also upload a Birth Certifcate for all household member that are under the age of 18

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  • Drivers License Upload

    Please upload a drivers license or passport for for all household members 18 and over.

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  • Race and Ethnicity (Optional Disclosure).

  • Income

    This section applies to all adult household members 18 years of age or older
  • What type of income do you receive (check all that apply)*

  • Pay Stubs

  • How are pay stubs calculated?

    • Pay is calculated based on taking your current pay and projecting it over 12 months.
    • The projection is based on the average of your last 5 pay stubs or the average based on dividing your year-to-date gross income by the number of pay periods.
    • Bonuses, commissions, and overtime are calculated in this projection.  

    Additional Information:

    • Provide school transcript or proof of student status for dependent household members over the age of 18 and full‐time students.
    • Please include the income for any full-time students over age 18.
  • What state/city is this property located in?
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  • Employment Verification

     

    Please download the Employment Verification form here.

     

    You will need to have your employer(s) complete this form and then you will need to upload it to use in a seperate form.  We will email you a link to the form after you submit this application.

  • Employment Verification - Westchester

     

    Please download the Employment Verification form here.

     

    You will need to have your employer(s) complete this form and then you will need to upload it to use in a seperate form.  We will email you a link to the form after you submit this application.

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  • If you receive paychecks, have you been employed since 1/1 of this year?*

  • Self Employment

  • Do you work for with any employer that provides an earning statement? If yes, please select the following one of the following:*

  • Profit and Loss Statement

  • When did you start working? *
     - -

  • When self-employment income is sporadic or based upon commission, the projection of household income currently shall be based upon historical data unless:

    (1) The household can demonstrate and verify that it has experienced a change in circumstances that is a reliable indicator that its income has decreased and that the historical data is not a reasonable basis for projecting household income; or

    (2) Documentation indicates that the household has experienced a change in circumstance that is a reliable indicator that its income has increased and that the historical data is not a reasonable basis for projecting household income.

    b. When self-employment income is sporadic or based upon commission and there is no record of self-employment from the last year in which tax returns were filed, the projection of household income will be based solely upon the reliable year-to-date documentation.

     

  • Do you have additional self employment income?*
  • When did you start working? *
     - -

  • Uber Pay Statements - Instructions

    • Log in to the Uber Partner Dashboard
    • Select Tax Statement
    • Download the last available month and save it as a PDF.  If you are on your phone, you can click share and save it as a PDF.
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  • Social Security, Child Support, Alimony, Unemployment, Other Income

  • Social Security/ Social Security Disability: Provide an official statement of monthly amount received for year in review and statement of total amount received for latest tax year.

  • Child support/Alimony: Provide a document indicating the payment amount. Child support income shall be determined based upon the prior 12-month history. Lump sum payments for prior periods shall not be included in calculating the child support payments for the prior 12 months.

  • Pension: Provide a statement indicating the amount received for the year in review and a statement of the total amount received for the latest tax year.

  • Unemployment: if receiving unemployment, please provide copies of the unemployment checks.

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  • Child Support Affidavit

    Please complete this form if your household contains any minor children and only one adult. 

    Download and complete the Child Support Affidavit

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  • No Income Affidavit

  • I am an adult over 18 years of age, certify that I do not have any income from any source, both taxable income, and non-taxable income, including but not limited to: earnings, overtime, IRA distributions, part-time employment, bonuses, dividends, interest, annuities, pensions, Veteran Administration
    (VA) Compensation, gross rental or lease income, commissions, deferred income, welfare payments, social security benefits, disability payments, alimony, support payments, public assistance, sick pay, unemployment compensation, and income received from trusts, business activities, and investments.

    I understand that I have been included on the Application, and no income has been recorded for me on the application.

    I declare that under penalties of perjury that the foregoing representations are true, correct, accurate, complete and correct in all respects.

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  • Are there any more household members that receive no income?*

  • I am an adult over 18 years of age, certify that I do not have any income from any source, both taxable income, and non-taxable income, including but not limited to: earnings, overtime, IRA distributions, part-time employment, bonuses, dividends, interest, annuities, pensions, Veteran Administration
    (VA) Compensation, gross rental or lease income, commissions, deferred income, welfare payments, social security benefits, disability payments, alimony, support payments, public assistance, sick pay, unemployment compensation, and income received from trusts, business activities, and investments.

    I understand that I have been included on the Application, and no income has been recorded for me on the application.

    I declare that under penalties of perjury that the foregoing representations are true, correct, accurate, complete and correct in all respects.

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  • Assets

    This page will be blank if assets are not required for this application

  • Please include copies of the past 3 months of statements for all asset accounts and include all pages of statements.  Evidence of all assets must be provided, and all assets must be listed on this application. 

    This includes but is not limited to: checking, savings, stocks, pensions, CD’s, 401K’s, IRA’s, PayPal, Venmo, and Cash App.

  • Please select all the asset accounts that are in your name:*
  • Image of bank statement with text highlighted to show how many total pages there should be.
  • Image saying no screenshots accepted, please download the full monthly account statement as a PDF.
  • Please name files this way: Name of Bank - Month - Full Name"

  • Checking Accounts

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  • Savings Accounts

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  • Retirement Accounts

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  • Stock and Mutual Fund Accounts

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  • CD, Paypal, Venmo, Cash App or any other accounts not listed

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  • Deposits Over $100

  • Do you have any deposits $100 and over in any of your bank statements (CashApp and Venmo included)? This does not include payroll deposits for they pay stubs you provided. Any $100+ deposits must be documented, additional verification may be requested if there is any recurring income.*
  • Picture of bank statement highlightin deposits

  • Taxes

  • Did you file taxes last year?*

  • Please include copies of last years tax returns. This includes:

    • Tax Return (all pages and schedules)
    • W2s for all employment
    • 1099s for all income

    If you did not file taxes or have copies of your W2 or 1099 forms, you can request them here:

    https://www.irs.gov/individuals/get-transcript

    If you earn self-employment income, please provide 2 years of tax returns.

  • Please include copies of your last three (3) years of tax returns. This includes:

    • Federal Tax Returns (all pages/schedules)
    • W2s for all employment
    • 1099s for all employment

    If you did not file taxes or have copies of your W2 or 1099 forms, you can request a Wage and Income transcript from the IRS here:

    https://www.irs.gov/individuals/get-transcript

  • Did you work for any employers last year that you no longer work for this year? Think of any W2 jobs from last tax return you are no longer working.*

  • No Longer Employed Statement
    Previous Employer that you worked for this year or received a W2 or 1099 from last year.

    My name is   *   * . I am no longer employed by * . My last day of employment was   * .

    *        

  • No Longer Employed Statement
    Previous Employer that you worked for this year or received a W2 or 1099 from last year.

    My name is   *   * . I am no longer employed by * . My last day of employment was   * .

    *        

  • No Longer Employed Statement
    Previous Employer that you worked for this year or received a W2 or 1099 from last year.

    My name is   *   * . I am no longer employed by * . My last day of employment was   * .

    *        

  • No Longer Employed Statement
    Previous Employer that you worked for this year or received a W2 or 1099 from last year.

    My name is   *   * . I am no longer employed by * . My last day of employment was   * .

    *        

  • Federal Tax Return

  • Federal tax return 1040
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  • Picture of a W2 form
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  • Picture of a 1099 form
  • Did you receive any 1099s? Example above. This is provided for self employment, interest/dividends, retirement or SSI income.
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  • If you did not file taxes or have copies of your W2 or 1099 forms, you can request a 'Return Transcript' and 'Wage and Income Transcript' from the IRS here:

    https://www.irs.gov/individuals/get-transcript

    screenshot of IRS website tax transcripts

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  • If you do not have a Social Security # or Tax Identification (TIN) #, and you have not filed taxes, then please provide a notarized affidavit stating this.

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  • Mortgage Pre-Approval

    Please contact us if you are having difficulty with this.
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  • Lottery Preferences

  • Are you a First Time Home Buyer?*

  • Local Preference

    Local Preference is defined as a household that, at the time of application for an affordable housing unit, falls into the following category:

    1. Current residents of the town: A household in which one or more members is living in the city or town at the time of application. Documentation of residency should be provided, such as rent receipts, utility bills, street listing or voter registration listings.


    2. Municipal employees of the town: Employees of the municipality, such as teachers, janitors, firefighters, police officers, librarians, or town hall employees.


    3. Employees of Local Businesses: Employees of businesses located in the
    municipality.


    4. Households with children attending the locality’s schools.

    If “Yes”, please provide the appropriate supporting documentation.

    For current residents of the town, one of the following must be provided:

    • A utility bill dated within the past 60 days (electric, gas, oil, cable, interest, telephone, or cell phone bill)
    • A current signed lease agreement
    • Voter Registration

    For households that are applying as Municipal Employees or Employees of Local Businesses, the pay stubs provided for the income information would suffice if the paystubs show a town based address.

    Households with children attending the locality’s schools, a school transcript should be provided.

  • Do any household members meet the criteria for the local preference?*
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  • Household Size Preference (only applies to 2 Bedroom and 3 Bedroom units)

    Household Size Preference: Households are eligible for units of a particular bedroom type based on the following criteria:

    1. There is at least one occupant per bedroom

    2. A household may count an unborn child as a household member, if the pregnant household member is in the third trimester at the time of the lottery. The household must submit proof of pregnancy with the application.

    3. If the applicant is in the process of a divorce or separation, the applicant must provide proof that the divorce or separation has begun or has been finalized, as set forth in the application.

    Note: Occupancy will not be more restrictive than in the State Sanitary Code.

  • Acknowledgement

  • The parties hereby agree and covenant that the completion of the recertification by management shall not constitute a waiver of any notice to quit, notice voiding tenancy, notice terminating tenancy, summary process action, civil action, agreement/agreement for judgment, or any other rights which landlord may retain, and that the completion of this process and the execution of the related documentation is being performed at the tenant’s request and as an administrative accommodation to the tenant.  Without limiting the foregoing, the parties specifically agree that the execution of any interim recertification documents, including a HUD 50059, lease addendum, and/or other recertification documents, and/or landlord’s acceptance of any payments, shall not create any new tenancy or otherwise constitute a waiver of any rights.

  • Please note that Maloney Properties reserves the right to request additional documentation after reviewing the application. 

    In carrying out this marketing program and applicant selection process, neither the Owner nor Maloney Properties, Inc. will discriminate based on race, color, creed, religion, sex, familial status, sexual orientation, national or ethnic origin, handicap, citizenship, ancestry, or marital status, public assistance, gender identity or any other basis prohibited by law.

    Disabled persons are entitled to request a reasonable accommodation in rules, policies, practices, or services, or to request a reasonable modification in the housing, when such accommodations or modifications may be necessary to applicants with disabilities an equal opportunity to use and enjoy the housing.

    I understand that Maloney Properties, Inc. is relying on this information to prove my household’s eligibility. I certify that all information and answers to the above questions are true and complete to the best of my knowledge.  I consent to release the necessary information to determine my eligibility.  I understand that providing false information or making false statements may be grounds for the denial of my application. 

    I authorize my consent to have Maloney Properties, Inc. verify the information contained in this application for purposes of proving my eligibility for occupancy.  I will provide all necessary information and expedite this process in any way possible.  

  • All ADULT household members must sign below:

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