Neighbors of Watertown Rental Application

BYNOW MANAGEMENT, LLC
112 FRANKLIN STREET, WATERTOWN, NY 13601
Tel: (315) 782-8497

Checklist - Required Information to Submit With Your Application You Can Not Go On a Property Waiting List Until All Information Has Been Processed

*Your income and sources must be verified for property eligibility

1) Current and/or anticipated income sources.
As example(s) social services (welfare) benefit, social security or supplemental (SSI) income, retirement or pensions, award letters-verification of any and all income sources (i.e. employments, unemployment, if you are self-employed the year end income tax and/or self-employed statements, child support/custody verification, alimony agreements, or cash assistance for any source)

2) Name of ALL Banks you have accounts with.

3) Current information on all assets (i.e. property owner, business operations, and/or equipment).

4) Stock certificates, bonds, quarterly statement from your investment broker.

5) Copies of all insurance policies (i.e. life insurance policies with their cash surrender value: please have your insurance agents name, address, telephone number to verify policies and their cash value).

6) Addresses and phone number for all providers or caseworkers (i.e. assistance of benefit programs (i.e. social services (welfare); CAPC, CREDO, probation Dept., any other information relative to case management)

7) Proof of all household members to include identifications, social security numbers and birth certificates.

8) Out of pocket medical expenses in the last year: Includes receipts, RX copays, insurance, eyeglasses, office visit copays, etc. (Please note this is a HUD requirement only for people applying to our Bugbee, Centennial, or Henry Keep Apartments. It only applies if the head, spouse or co-head is 62 years or older or is disabled).

9) Most recent tax returns.

10 Form 4506-c: Request for Transcript of Tax Return. Download from IRS Here

** All required documents must be submitted within 10 business days.

Documents can be scanned and emailed to This email address is being protected from spambots. You need JavaScript enabled to view it., or dropped off at our office. 112 Franklin St., Watertown, weekdays from 8 am - 4 pm.

Download Required Documents list as PDF.

First Name

Last Name

SS #

Marital Status

Date of Birth

Full Time Student

Yes

Address

Address Line 2

City

State

Zip

Home Phone #

Email Address

Additional Household Members:

First name

Last Name

Relationship

Date of Birth

Full Time Student

First Name

Last name

Relationship

Date of Birth

Full time Student

Yes

Income Source for all household members

You are required to enter at least one source of income into the boxes below. You may add more than one income source by clicking the green button below, but this is optional.

Frequency

Income Source

Gross Amount (Before Deductions)

Income Source

Gross Amount (Before Deductions)

Frequency

Have you ever participated in a rental subsidy program?

Yes

Were you 62 or older as of Jan 31, 2010 and did not have a SSN?

Yes

Have you ever rented from Neighbors of Watertown in the past?

Yes

Optional Information Requested: "The information regarding race, national origin, and sex designation solicited on this application is requested in order to assure the Federal government that federal laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age, and handicap are complied with. You are not required to furnish this information but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race/ethnicity and sex of individual applicants based on visual observation and/or surname."

Does your household meet the definition of homeless? (Family lacks a fixed regular and adequate night time residence, or has a primary night time residence that is a supervised publicly or privately operated shelter designed to provide temporary living accommodations such as welfare voucher hotels, congregate shelters or transitional housing designed for homeless persons, or a public or private place not designed for, or ordinarily used as a regular sleeping accommodation for human beings)

Yes

If Yes, a Homeless Verification Form MUST be included with your application. Download Here.

Have you or anyone in your household ever been arrested, charged or convicted of any crime?

Yes

Are you or any member of the household subject to a lifetime sex offender registration?

Yes

Building/Property Desired

# of bedrooms

Date of occupancy you are interested in?

Month

Day

Year

Do you have any pets?

Yes

*MOST OF OUR PROPERTIES ARE ONLY APPROVED FOR SERVICE ANIMALS. VET PAPERS REQUIRED PRIOR TO MOVE-IN.

Would you be interested in our apartments in Philadelphia, NY

Yes

Do you have any out-of-pocket medical expenses?

Yes

Do you have needs that would require special accomodations?

Hearing Impaired Unit

Visually Impaired Unit

Wheelchair Accessible Unit

Are you mobility impaired? (Will have to be verified by a medical professional)

Yes

Name of Medical Professional

Rental History

Please List all states in which you have lived

Current Living Situation

Present Address

Length of time at this address

Date Rented

Date Moved

Amount of Rent (dollars)

Utilities Included?

Yes

Landlord Name

Phone

Address

Reason for moving

Previous Living Situations

Previous Address

Length of time at this address

Date Rented

Date Moved

Amount of Rent (dollars)

Utilities Included?

Yes

Landlord Name

Phone

Address

Reason for Moving

Previous Address

Length of time at this address

Date Rented

Date Moved

Amount of Rent (dollars)

Utilities Included?

Yes

Landlord Name

Phone

Address

Reason for Moving

Name of Nearest Relative

Relation

Address

Phone

Were you referred by someone?

Yes

How did you hear about us?

The undersigned hereby certifies that the above information is true and correct to the best of my/our knowledge and belief. I/we give Neighbors of Watertown authorization to check landlord and character references, mobility impairment and other sources as necessary to do credit and/or criminal history checks as required. I/We understand and agree that if I/we have been found to have willfully made mistruths or omissions on this application then I/we will no longer be considered for an apartment.

Signature required for all household members age 18 and above:

Applicant Signature

Date

Please Sign

Date

Please Sign

Date

Please Sign

Date

Please Sign

Date

Was this application completed by someone not listed as a member of the applicant household?

Yes

Neighbors of Watertown Rental Application

Checklist - Required Information to Submit With Your Application You Can Not Go On a Property Waiting List Until All Information Has Been Processed

*Your income and sources must be verified for property eligibility

Additional Household Members:

Income Source for all household members

Rental History

Current Living Situation

Previous Living Situations

Signature required for all household members age 18 and above:

Please Complete:

Residental Properties