Northern California Land Trust Housing Application

Thank you for your interest in the current 1-bedroom vacancy at Peace Gardens, located at 484-486 36th St in Oakland, CA (read more about the community below). 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. APPLICATIONS ARE DUE MONDAY, APRIL 17, 2023.

Interpretation services can be provided if applicants need assistance in other languages. -- Se pueden proporcionar servicios de interpretación si los solicitantes necesitan asistencia en otros idiomas.

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, ext 540 or email housing@nclt.org.

Income Requirements

Applicant household total combined GROSS ANNUAL income (of ALL household members) cannot exceed 60% of the Area Median Income (AMI)*

Household Size	1 person	2 person	3 person
60% AMI	$57,563	$65,775	$73,988

*60% Area Median Income (AMI) Table pursuant to 2022 HUD Standards for Alameda County

PEACE GARDENS & NCLT

I have read and agree to the Peace Gardens House Rules

YesNo

I have watched the CLT Orientation Video (the property featured at the end of the video is another property).

YesNo

I have watched the Virtual Tour of the vacant unit.

YesNo

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.

Applicant Name

Edit this text

Current Mailing Address (street and number)

City, State

Zip

Phone

Email

Do you currently reside at Mailing Address Listed Here

YesNo

Co-Applicant Name

Edit this text

Current Mailing Address (street and number)

City, State

Zip

Phone

Email

Do you currently reside at Mailing Address Listed Here

YesNo

Please provide the following information for the past 3 years of residence: Address(es), Move-in date(s), move out date(s), reason(s) for moving, owner name(s), owner phone number(s)

HOUSEHOLD INFORMATION (Please list all members of the household, including yourself)

	Name	Birthday	Gender	Social Security #	Relationship to Applicant

Do you have any dependents who are not household members (i.e. do not live with you for over 6 months of the year)?

YesNo

CURRENT MONTLY RENT:

CITIZENSHIP STATUS OF APPLICANT:

US CitizenPermanent Resident Non-Resident

FINANCIAL INFORMATION

Household Member Name

Employer Name

Employer Address

Employer Phone

State

Position Title

Start Date:

End Date:

Gross Monthly Income

Pay Cycle

Bi-MonthlyMonthlyOther

Other

OTHER INCOME (Please list other income for all members of the household. Please include SSI, AFDC, alimony, etc.)

	Name	Source	Gross Monthly Income

Total Adjusted Gross Annual Income for 2021 from tax return

Total Adjusted Gross Annual Income for 2020 from tax return

Total Adjusted Gross Annual Income for 2019 from tax return

If you have not filed a recent tax return, please explain why and offer alternative documentation of income, if possible.

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 (you can get a free credit report at www.experian.com)

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

Do you have Section 8?

YesNo

With which Housing Authority (which city) is your Section 8 housing certificate?

REVIEW & SELECTION OF APPLICANTS

CITY OF OAKLAND PREFERENCES: As required by the lender – the City of Oakland – this application process gives preference to residents of the City of Oakland, individuals who work in the City of Oakland, and individuals who have been displaced from the City of Oakland. Applicants will be asked to provide documentation for these preferences. Do you qualify for any of the below City of Oakland Preferences?

YesNo

Which preferences do you qualify for?

Review & Selection Process:

All complete applications submitted by the deadline will be reviewed by staff for income and household size eligibility (as detailed in Section IV, below). Incomplete or late applications will not be considered. Staff will follow Oakland’s Fair Chance Access to Housing Ordinance No. 13581 C.M.S. (O.M.C. 8.25).

As NCLT receives applications, they will sort applications per preference (see full definitions below):

Displaced households
Neighborhood resident
Work and Live in Oakland
No preference

NCLT will go through each preference category one at a time (starting with the first displaced preference/category), in the order that applications were received, and review for general eligibility. Up to 20 eligible applications will be sent to the Peace Gardens vacancy committee to assess fitness for the community.

Interviews

Up to 20 eligible applicants will be invited to participate in an interview conducted by the vacancy committee of the project. The interviews will be conducted at the property, NCLT’s office or via zoom if in-person interviews are not possible. The number of interviewees may be reduced if necessary to fill vacancies in a timely manner; the Regulatory Agreement with the City of Oakland states that vacancies must be filled within 2 months.

The questions for the interview will be provided to applicant households prior to the interview. All households will be asked the same set of questions in the same order, and all questions relate directly to the applicant’s potential for success in the project’s cooperative living environment. Any input given by the applicant household that does not respond directly to one of the questions asked during the interview will be disregarded and will not be a factor in the scoring. For each vacant unit, a minimum threshold score will be set – any applicant scoring below that will not be eligible for the unit. For applicants who score above the minimum score, they shall be ordered according to the interview scores.

Notification:

1. Incomplete & Late Applications

Prospective residents who submit incomplete applications, late applications, or applications that do not meet income and size criteria will be notified that the substance of their application will not be reviewed. The notification of non-consideration will be emailed to the email address provided on the application, or via US 1^stClass Mail if no email address is provided.

2. Reviewed & Unreviewed Applications

Up to 5 eligible households who meet initial income and household size criteria will be notified of their invitation to sit for an interview. Any applications that were reviewed but didn’t meet eligibility criteria will be notified. Any unreviewed applications will be notified that they didn’t make it into 5 finalists per the above review process. This notification will be sent via the email provided on the application, or via US 1st Class Mail if no email address is provided. The first five (5) ranked households will be invited to provide proof of eligibility for the preferences and – upon submission of this proof – to sit for an interview. After interviews are completed, all households who participated in an interview will be notified of their status via the email provided on the application, or via US 1st Class Mail if no email address is provided. Any household offered a unit must provide the necessary income, asset and household verification documentation within seven (7) days of notification.

Once an applicant is offered the unit, accepts the unit, and provides the required documentation and deposit such that they have secured the unit, all other eligible households who applied will be notified of their status, as well as appeal and waitlist procedures.

Selection – Requirements & Prioritization

Income Requirements & Recommendations

Applicant household total combined GROSS ANNUAL income (of ALL household members) cannot exceed 60% of the Area Median Income (AMI)*

Household Size	1 person	2 person	3 person
60% AMI	$57,563	$65,775	$73,988

*60% Area Median Income (AMI) Table pursuant to 2022 HUD Standards for Alameda County

City of Oakland Local Preferences

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.

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. You can contact NCLT's Executive Director at Ian.winters@nclt.org.

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.