Pre-Rental Application Form | Caldwell Housing Authority

Today's Date

Fee Notice

You are about to fill out a “pre-application” for housing with the Caldwell Housing Authority (CHA). The “pre-application” process allows CHA to pre-screen applications. The application fee is $20 .00 for every adult household member. Your application will not be considered unless the application fee is paid in full. Are you willing to pay the application fee?*

Yes
No

Waiting List Notice

Once the application has been completed, you will be placed on a waiting list in priority order according to the occupancy policy. Are willing to be placed on a waiting list?*

Yes
No

Disqualification

CHA uses a third-party vendor to help screen applicants. Some applicants with certain criminal backgrounds may be disqualified. Felonies within the last seven (7) years, recent drug-related charges, and/or poor rental history, inadequate income or credit may disqualify some applicants. Do you authorize CHA to conduct a background check?*

Yes
No

(If you select NO your application will not be considered)

Veterans Status

CHA provides housing preferences to Veterans who meet the eligibility criteria. Is the applicant or a co-applicant a Veteran of the U.S. Armed Forces?

Yes
No

Workforce Preference

CHA provides housing preferences to applicants who work in the greater Caldwell area and who meet the eligibility criteria. Applicants who are employed by organizations or businesses with an 83605, 83606, and 83607 zip-code may qualify for the preference. What percentage of your household income comes from employers with the aforementioned zip-codes?*

81-100%
50-80%
Less than 50%

Farmworker Status

Does any of your household income come from farm work or farm labor?*

Yes
No

Applicant

First Name*

Middle Name

Last Name*

Date of Birth:*

Age:*

Gender:*

Male
Female

Citizenship Status:*

U.S. Citizen
Resident Alien

Applicant Cell Phone #

Applicant Email

Co-Applicant

(Must be over 18)

First Name

Middle Name

Last Name

Date of Birth:

Age:

Gender:

Male
Female

Citizenship Status:

U.S. Citizen
Resident Alien

Co-Applicant Cell Phone #

Co-Applicant Email

Residing Family Members

Other than applicant & co-applicant, how many dependant children will occupy the unit?*

Family Member #1

Name

First Last

Age:

Gender:

Male
Female

Family Member #2

Name

First Last

Age:

Gender:

Male
Female

Family Member #3

Name

First Last

Age:

Gender:

Male
Female

Family Member #4

Name

First Last

Age:

Gender:

Male
Female

Family Member #5

Name

First Last

Age:

Gender:

Male
Female

Family Member #6

Name

First Last

Age:

Gender:

Male
Female

Current Address

Address Suite City State ZIP Code

How long at this current Address?

Current Living Situation:

Own
Rent
Living with friend or relative
Shelter

Do you have a previous address?*

Yes
No

Previous Address #1

Address Suite City State ZIP / Postal Code

Landlord Name

Landlord Phone #:

Do you have another previous address?

Yes
No

Previous Address #2

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Landlord Name

Landlord Phone #:

Hidden

Household Composition

Number of Adults (18 years or older)

Number of Children (17 years or younger)

Total Occupants:

Household Annual Income*

$9,200—$16,064
$16,065—$24,949
$24,950—$35,948
$35,949—$76,673
$76,673 or more

General Information

Emergency Contact Phone Number:*

Will this be your Primary Residence?*

Yes
No

Have you ever been evicted from rental housing?*

Yes
No

Have you rented from the Caldwell Housing Authority before?*

Yes
No

Do you have any relatives who rent with the Caldwell Housing Authority?*

Yes
No

If yes, what apartment do they live in?

Do you have any relatives who work for the Caldwell Housing Authority?*

Yes
No

Do you authorize the Caldwell Housing Authority to retrieve financial information from the Department of Labor for all household members 18 years of age or older?*

Yes
No

Do you authorize the Caldwell Housing Authority to contact your previous landlord(s)?*

Yes
No

Do you authorize the Caldwell Housing Authority to conduct criminal background checks on all household members 18 years of age or older?*

Yes
No

Do you authorize the Caldwell Housing Authority to retrieve credit-related information from the appropriate agencies for all household members 18 years of age or older?*

Yes
No

All information provided on this application must be verified with additional information such as I.D. cards, Social Security Cards, pay stubs, tax returns, etc.. If you are eligible to rent from the Caldwell Housing Authority, a representative will call you and ask for the necessary information.

Rental Pre-Application WebForm

Fee Notice

Waiting List Notice

Disqualification

Veterans Status

Workforce Preference

Farmworker Status

Applicant

Co-Applicant

Residing Family Members

Family Member #1

Family Member #2

Family Member #3

Family Member #4

Family Member #5

Family Member #6

Current Address

Previous Address #1

Previous Address #2

Household Composition

General Information