Somerville - Lottery Pre-Screening Rental Application
  • 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.

  • Image field 342

  • Lottery - Rental Pre-Screening Application

  • Which unit size are you applying for? (Please review which bedroom sizes are available before selecting). You may apply for more than one option. Please note - Somerville has a 1-person-per-bedroom requirement for units with 2+ Bedrooms (unless a 1-Person Household can submit verification of need from your health care provider with this application before the application deadline).*
  • 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 a Housing Voucher?*
  • If you are a mobile rental voucher holder, you have the option of being placed in the pool that contain the most units for which you are applying and eligible.* Select "Yes" if you would like to be placed in that pool.*

  • *If there are the same number of units in all tiers, you will be placed in the tier for which you are income eligible by default.

  • Does your household need a fully accessible unit for someone with a mobility or hearing impairment? (Please review if any ADA units are being offered at the property)*
  • Are you a Certified Artist through the Somerville Arts Council or in the process of applying for artist certification?*

  • Income Information

  • What type of income do you receive (check all that apply)*

  • Paychecks

  • 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 all that apply:*

  • Self-Employment Income

  • Social Security, Child Support, Alimony, Other Income

  • Asset Information

  • 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:

    • Current residents of the town: A household in which one or more members are living in the city or town at the time of application. Documentation of residency should be provided, such as rent receipts, utility bills, street listings, or voter registration listings.
    • Municipal Employees of the town: Employees of the municipality, such as teachers, janitors, firefighters, police officers, librarians, or town hall employees.
    • Employees of Local Businesses: Employees of businesses located in the
      municipality. (20+ hours a week)
    • Households with children in Somerville Public Schools or Somerville charter schools.

     

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

     

    For Current residents of Somerville, one (1) of the following must be provided:

    • A Current Signed Lease Agreement
    • Voter Registration
    • A Utility Bill dated within the past 30 days (electricity, gas, oil, water/sewer, cable, internet, landline phone, or cell phone bill)
    • Current Bank Statement
    • Letter from a Somerville-based shelter
    • If a lease cannot be provided, a signed & dated letter by the landlord identifying the applicant, address & proof of ownership may suffice in some instances.
    • Notarized letter signed under the pains and penalties of perjury from leaseholder verifying sub-tenancy and including lease of leaseholder.


    For Municipal Employees or Employees of Local Somerville Businesses:

    • The paystub provided for the income information would suffice if it shows a Somerville-based address and is dated within 30 days.
    • If a paystub cannot be provided, a letter of employment by the applicant’s Human Resources Director or Payroll Director on company letterhead with contact information may be provided. The letter must state the employee’s name, location of employment & the number of hours working in Somerville per week. The letter must be dated within 30 days from the date the completed pre-lottery application is submitted. Somerville work preferences may not be granted for households providing co-working spaces as verification of employment in Somerville.


    For Households with children in Somerville Public Schools or Somerville charter schools:

    • School record for child/children (22 years of age and under) with current address.
    • Current letter or school transcript from SPS or a charter school in Somerville.
    • During the summer break period:
      • Documentation must include proof of most recent year enrollment and should be provided prior to the beginning of the new school year as well as notice of intent to re-enroll.

     

    Important

    Please note you can still apply even if you do not qualify for the local preference. 

  • Do any household members meet the criteria for the local preference?*

  • Acknowledgment

  • Please note that this is a preliminary rental lottery application and in no way insures occupancy.  Once you submit the application by the deadline provide, then your name will be entered into the lottery.

     

  • Clear
  • Clear
  • Clear
  • Image field 312
  • Should be Empty: