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Hello Cupertino Resident!

For tenants of the City of Cupertino Below Market Rate Rental program, we have created this online form which allows each household to submit their recertification and upload their supporting documents, securely, online. Once you submit your form and documents, they will transfer into our client management system. Please be assured your information is treated as strictly confidential and is never shared beyond Rise Housing and the City of Cupertino.

All recertifications must be received by the date indicated in your recertification letter/email. Recertifications will not be accepted in person, with no exceptions.

If you have any questions or concerns or if you are in need of interpretation, please email cupertino@risehousing.com or call (415) 301-5448.

Thanks!

Rise Housing Team

Non-Discrimination Policy

Rise Housing and the City of Cupertino do not discriminate against any persons on the grounds of race, color, religion, national origin, ancestry, sex, gender, gender identity, gender expression, sexual orientation, marital status, familial status, source of income, genetic information, medical condition, physical disability or mental disability, or any other category protected by law.

Document Checklist

Please review the following to ensure you successfully submit a complete recertification. The items below are required for all adult household members aged 18 and over.

A. Documentation of Income

Employment information, including paystubs for the past two (2) months
If self-employed, YTD Profit & Loss Statement
Gross annual income for each additional income source such as SSI, Pension/Annuity, Gift Income , child/spousal support etc. for the past two (2) months
If a household member is NOT earning income, please include a Zero-Income Affidavit (If needed, please request from Rise Housing)

B. Tax Documents

Most recent tax year Federal 1040 Tax Return
4506-t Verification of Non-Filing Form
Most recent tax year W-2s/1099s

C. Financial Accounts

The most recent two (2) consecutive statements for all financial accounts including bank, retirement, stocks/mutual funds, CDs etc.
Documentation for any unlabeled deposits on your bank account for over $500

Tip, don't forget to save your progress along the way!

If you are not able to finish filling out the recertification in one sitting, please follow these steps:

Click the "Save my progress and resume later" link at the bottom of any page.
You'll be prompted to submit an email and password.
Afterwards you'll receive an email with a link that can be used later to open the recertification and continue working.
When you return to complete the form, you will need to provide the same email and password.

Household Financial Account Information & Statements

The information you provide on this page helps determine your eligibility for the financial requirements of the City of Cupertino BMR Program.

Please upload statements for all open accounts for all household members aged 18 and over, even if they contain a $0 balance. Assets will be verified based on the supporting documentation submitted with this recertification, so please be sure to provide accurate information.

Bank & Financial Accounts

Please upload the last two (2) consecutive statements from this account

Account Owner

Bank or Financial Institution

Current Account Balance

Deposit Clarifications

Please provide a written explanation for any unlabeled deposits over $500 in the box below.

Backup documentation such as cancelled check, paystub, etc.

Certification of Information

By checking this box, and writing my name in the space below, I certify that the foregoing certification accurately reflects all income received from all sources for all members of the household.

I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct to the best of my knowledge. I further understand that providing false representations herein constitutes an act of fraud and that false, misleading, or incomplete information may result in the termination of real estate purchase documents related to this application (28 U.S. Code 1746).

First Name

Last Name

Date

Ready to Submit?

All required fields must be filled in before you can submit your paperwork.
Any required fields left blank will be highlighted in red when you attempt to submit your recertification.
Once your recertification is submitted, you will receive a confirmation email.