Northern California Land Trust Housing Application

Thank you for your interest in NCLT’s housing program. NCLT proudly complies with the provisions of federal, state and local law prohibiting discrimination in housing on the basis of marital status, race, color, religion, ancestry, sex, sexual orientation, age, national origin, Acquired Immune Deficiency Syndrome (AIDS), or AIDS related conditions, physical disability or any other arbitrary basis.


PLEASE FILL OUT EACH SECTION OF THIS APPLICATION AS COMPLETELY AS POSSIBLE.


If a question does not apply to you, please write N/A in the space provided. If you have any questions about the application, please call (510) 548-7878 or email sima.savdharia@nclt.org or sarah.scruggs@nclt.org.

CONTACT INFORMATION

A co-applicant listed below may be contacted in the event that NCLT is unable to reach the primary applicant, and the co-applicant should be authorized to make housing decisions for the applicant household. Please note: It is not necessary to list a co-applicant.


















HOUSEHOLD INFORMATION (Please list all members of the household, including yourself)
Name Birthday Gender Social Security # Relationship to Applicant









FINANCIAL INFORMATION










Name Source Gross Monthly Income




FINANCIAL DOCUMENTATION
NCLT requires ADDITIONAL DOCUMENTS to prove your income and eligibility. Without these documents, you application will be incomplete and you will not be eligible for the housing unit until you provide them (or acceptable substitutes). Documents to prove your income and eligibility.  Please attach all of the following:
  • A government issued photo ID or other acceptable form of verification of identity
  • Income Documentation:
    • Three most recent pay stubs and/or benefit statements for all adult household members. If self-employed, please include accounts that show your income for the past 3 months.
    • Your most recent Federal Tax Return and tax ID or social security number (or an an explanation for why you have not filed) for all adult household members
    • A recent credit report with credit score for all potential household leaseholders
If you are qualified and chosen as a potential tenant, NCLT may ask for a $25.00 credit check fee, payable to NCLT. You will receive a copy to this report for your records.
ASSETS
Please indicate type of assets and amounts for all adult members of household
TOTAL ASSET VALUE AVAILABLE FUNDS INSTITUTION NAME
Cash
Checking Account
Checking Account
Savings Account
Savings Account
Retirement Account
Money Market/Mutual Fund
Other
CREDIT INFORMATION
LIABILITES. Please include debts and amounts for applicant and co-applicant only.
OUTSTANDING BALANCE MONTHLY PAYMENT DELINQUENT? Y/N CREDITOR NAME
Credit Card
Credit Card
Credit Card
Lease Payments
School Loans
Store Accounts
Medical Bills
Other
HOUSING INFORMATION



1.  First preference: to displaced households. For purposes of this Section, a "displaced household" means a household in which a least one adult member has been displaced from a housing unit in Oakland as a result of any of the following:

  • City code enforcement activities, if the displacement has occurred within one year prior to the date of application.
  • A City-sponsored or City-assisted development project, if the displacement has occurred within one year prior to the date of application.
  • A "no fault" eviction from a rental unit in Oakland, if the eviction was completed eight (8) years or less prior to the date of application. For purposes of this paragraph, a "no fault" eviction means an eviction that is evidenced by an eviction notice from the property owner that does not state cause and that gives the tenant thirty (30) days or longer notice to vacate the unit; a "no fault" eviction shall include, but not be limited to an eviction as a result of an owner move-in under Municipal Code Subsection 8.22.360.A.8. or 8.22.360.A.9., owner repairs under Municipal Code Subsection 8.22.360.A.10., or owner removal of the unit from the rental market under Municipal Code Subsection 8.22.360.A.11. or Municipal Code Chapter 8.22, Article III, but shall not be limited only to evictions from units that are covered by any of the above laws. This preference shall apply to the initial rental or sale of a project unit and any subsequent rental or sale of a unit during the applicable affordability period established by the City.
2.  Second preference: to neighborhood residents. For purposes of this Section, a "neighborhood resident" means a household with at least one adult member whose principal place of residence on the date of application is either within the Council District where the project is located or within a one mile radius of said project. This preference shall apply to thirty percent (30%) of all units in the project. This preference shall apply only to the initial rental or sale of a project unit after the City's development assistance has been given to the project.


3.  Third preference: to Oakland residents and Oakland workers. For purposes of this Section, an "Oakland resident" means a household with at least one adult member whose principal place of residence on the date of application is within the City of Oakland. An "Oakland worker" means a household with at least one adult member who is employed by an employer located within the City of Oakland, owns a business located within the City of Oakland, or participates in an education or job training program located within the City of Oakland. This preference shall apply to the initial rental or sale of a project unit and any subsequent rental or sale of a unit during the applicable affordability period established by the City.1 - Certificate of Preference (COP) - Certificate of Preference holders who were displaced in the 1960’s and early 1970’s by the San Francisco Redevelopment Agency. City & County of San Francisco’s Mayor’s Office of Housing & Community Development administers this program and NCLT will verify such Certificate of Preference holders.

NARRATIVE QUESTIONS





If you wish to appeal the selection decision after applying for a particular opening, you may submit a written appeal to NCLT’s Executive Director within 5 business days of the receipt of the notification of rejection. NCLT will provide the applicant with a written response within 5 business days of the receipt of the appeal.

CREDIT REPORT AUTHORIZATION AND PRIVACY DISCLOSURE

Applicant represents that all of the above statements are true and correct and hereby authorizes their verification including, but not limited to, the obtaining of a credit report and agrees to furnish additional credit references on request. 


Owner/Agent is authorized to obtain a credit report as evidenced by signing below. Applicant expressly authorizes Landlord to contact all persons or firms named as references, former landlords and employers to verify the contents of this Application.


In connection with my application for rental, I understand that background inquiries will be made on myself including consumer, criminal, driving and other reports. Employment reports may include information as to my character, work habits, performance and experience along with reasons for termination of past employment from previous employers. I understand that information will be requested from various federal, state and other agencies and entities, public and private, which maintain records concerning my past activities relating to driving, credit, criminal, civil and other experiences as well as claims involving me in insurance company files.


I authorize, without reservation, any party or agency contacted, to furnish completely and without limitation, any and all of the above mentioned information and any other information related thereto. Further, I will release from liability and will defend and hold harmless all requesters and suppliers of information in accordance herewith.


By submitting this application, the applicant makes application to rent housing accommodations designated for the amount and location as set forth above and upon approval of this application agrees to sign a rental or lease agreement and to pay all sums due, including requested deposits before occupancy. Fraudulent information herein will result in automatic denial of application.