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Application for Rentals, Housing and Land Purchase

Please complete the Application below and select "submit" when finished.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Housing Opportunities (select One)

What Property or Rental are You Applying For?

Household Information

Head of Household

First Name

Last Name

Date of Birth

YYYY

Use this area to include other members of the household and their birthdates

Income Information

COMPLETE THE SECTION BELOW FOR EACH HOUSEHOLD MEMBER WHO HAS INCOME: PLEASE NOTE THAT ALL INCOME INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL.

Household Member 1

First Name

Last Name

Income

Ex, 30000; do not use commas.

Frequency

I.e. Weekly, Bi-weekly, Monthly, etc.

Employer/Income Source

Years Employed

Household Member 2

First Name

Last Name

Estimated Income

Ex, 30000; do not use commas. Income will be verified by submitting financial documents (tax returns etc.)

Frequency

Employer/Income Source

Years Employed

Other Income or Savings

Please list the total of any savings accounts, securities, retirement accounts, or other sources of income below:

References

Can be current landlord, past landlord, and employers

Reference 1

First Name

Last Name

Contact Info

Email, phone, address, etc.

Dates

Reference 2

First Name

Last Name

Contact Info

Email, phone, address, etc.

Dates

Are you a full time resident of North Haven?

Yes

If Yes, How Many Years Have You Lived in North Haven?

Do You Own Land or Property Elsewhere in North Haven? If So, Please Provide Detail Below.

Type "No" if no property is owned.

Do You Own Land or Property Elsewhere Off North Haven? If So, Please Provide Detail Below.

Type "No" if no property is owned.

Are You Prepared to Agree in Writing that You Will Make this Land/House Your Primary Residence?

Yes

Additional Information

Please include any additional information you would like the selection committee to see on this application.

Upload Files Here (I.e. Tax returns, Mortgage pre-qualification etc. as required.) Please note that this is a secure link, but please use at your own risk. You can also send hard copies to PO Box 373 North Haven, ME 04853

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