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1 Affordable Unit Application The Enon 8 Enon Street, Beverly, MA This is an important document. If you require language interpretation, please contact the agent for this development directly ([EMAIL REDACTED] or [PHONE REDACTED] x3) and request interpretation services in your own language. If the agent does not speak your primary language they will contact a translator who will provide language assistance. Este es un documento importante. Si necesita interpretación de idiomas, comuníquese directamente con el agente de este desarrollo ([EMAIL REDACTED] y [PHONE REDACTED] x3) y solicite servicios de interpretación en su propio idioma. Si el agente no habla su idioma principal, se pondrá en contacto con un traductor para que proporcione que brindará asistencia lingüística. Applications must be received by December 3, 2024 at 2:00 pm Applications postmarked by the deadline must be received no later than 5 business days after the deadline. YOU CAN COMPLETE AND SUBMIT A LOTTERY APPLICATION ONLINE HERE: MAXIMUM Household Income Limits: $62,538 (1 person), $71,472 (2 people); $80,406 (3 people); $89,340 (4 people) Affordable Rents: $1,427 (1 Bedroom); $1,524 (2 Bedroom). Tenants will be responsible for paying for electricity (cooking/heating/hot water), cold water, and sewer. One parking space per unit is available for residents and is included in the rent. Pets are permitted, subject to restrictions. *Rents are subject to change in future years. Households must make approximately $42,800 to lease a 1BR unit, and $45,700 to lease a 2BR unit (please read the Information Packet for more details). This is not subsidized housing. Rents do not change based on applicant’s income and tenants who do not already have housing subsidies (like Section 8 vouchers) will be responsible for paying the full rent themselves. Applicants with a housing subsidy are encouraged to contact the housing agency who issues their housing subsidy to confirm that the rents are within the agency’s payment standards to ensure that they will not be prohibited by the housing agency from using the housing subsidy at this property. Please read the Information Packet for more details. Units are expected to be available for occupancy immediately following the lottery. Directions: Online Applications can be completed and submitted at the JOTFORM link above. If you’d prefer to submit a paper/PDF application, it must be submitted by the date at the top of this page. This application must be filled out entirely for your application to be processed. Send or drop off all applications by the date above to: SEB Housing (Re: The Enon), 257 Hillside Ave, Needham, MA 02135; Fax: (617) 782-4500; Phone: (617) 782-6900; Email: [EMAIL REDACTED] This development does not discriminate in the selection of applicants on the basis of race, color, national origin, disability, age, ancestry, children, familial status, genetic information, marital status, public assistance recipiency, religion, sex, sexual orientation, gender identity, veteran/military status, or any other basis prohibited by law. ---PAGE BREAK--- 2 The Enon. Please provide all the following contact information for the Head of Household (please print clearly): Applicant’s Name: Address: City: State: Zip: Home Phone:( ) Work Phone:( ) Cell Phone:( ) Employer: Email address (if available): @ Please note: Providing your email should facilitate the process of completing your application as you will be notified of missing documentation faster than if we can only send notifications via postal mail. If you do not provide your email address or do not have an email address, we will contact you via postal mail. We will not contact you about future lotteries unless requested. Anticipated Move-In/Lease Renewal Date: Bedroom Size Information: For which bedroom size(s) are you applying (you may select more than one) 1 Bedroom 2 Bedroom Do you currently receive or do you have a Section 8 mobile voucher or certificate? (The Lottery Agent does not discriminate based on source of income. This question is asked for the sole purpose of determining ability to pay rent.) Yes No Please fill out the chart below for everyone who will be occupying the unit: I certify that my Household Size is (total number of household members) Initial(s): Initial(s): NAME AGE HEAD OF HOUSEHOLD OR DEPENDENT RELATIONSHIP TO APPLICANT LISTED AT THE TOP OF THIS PAGE IS THIS PERSON A FULL-TIME STUDENT OR WILL BE A FULL- TIME STUDENT IN THE NEXT 12 MONTHS? Yes No Yes No Yes No Yes No ---PAGE BREAK--- 3 HOUSEHOLD TYPE (please check one, read the Information Packet for more details): □ 1 person household (Type I) □ 1 person household with a disability or medical need for TWO bedrooms (Please note that verification from medical provider of need for a 2BR unit will be required at certification otherwise household may be removed from Waiting Lists) (Type II) □ 2 person household: 2 heads-of-household (Type I) □ 2 person household: 1 head-of-household plus one dependent (Type II) □ 2 person household with a disability or medical need: 2 heads-of-household where heads-of-household cannot be required to share a bedroom as a consequence of sharing would be a severe adverse impact on their mental or physical health OR there is a separate disability or medical need for two bedrooms. (In either case, please note that verification from medical provider of need for separate rooms for heads of households or of need for a 2BR unit will be required at certification otherwise household may be removed from Waiting Lists) (Type II) □ 3 person household: all types (Type II) □ 4 person household: all types (Type II) PREFERENCE INFORMATION (Please note that documentation will be required to verify preferences AFTER the lottery and households who incorrectly apply for a preference will be dropped from all waiting lists) Do you or any member of your household qualify for Local Preference? An applicant qualifies for local preference if the applicant or a member of their household fit into one of the following categories a current resident of Beverly, an employee of the City of Beverly (including Beverly Public Schools) or an employee of a business located within the City of Beverly or a parent or guardian with children attending the Beverly Schools (including METCO students) Yes No If you answered “Yes”for Local Preference you will need to attach the documentation specified below AFTER THE LOTTERY and failure to provide the requirement documentation may result in the applicant being dropped entirely from ALL Waiting Lists: If qualifying under definition as detailed above: I will have to submit a Copy of two utility bills 1 from each utility company in my name dated within the last 60 days, e.g., electric, oil, cable, gas, or telephone landline (not cell phone). If utility bills cannot be provided the following documentation must be provided: current signed lease AND proof of voter registration from City of Beverly Election Department If qualifying under definition as detailed above: I will have to submit copies of pay-stubs AND IF THE PAY STUBS DO NOT SHOW THE ADDRESS OF THE JOB I have submitted a signed statement from my employer on company letterhead the states the address of the job and the employee’s name. If qualifying under definition as detailed above: I will have to submit copies of Beverly school transcripts AND proof of relation to the student (by birth certificate or legal guardianship or divorce decree) ---PAGE BREAK--- 4 RACE: (OPTIONAL) You are requested to complete the following optional section in order to assist in determining preference. Completing this section may qualify you for additional lottery pools. (Please check all boxes that apply): Alaskan Native and Native American Asian Black or African American Native Hawaiian or Pacific Islander Hispanic or Latino White (not of Hispanic origin) Other (please specify)___ REASONABLE ACCOMMODATION Persons with disabilities are entitled to request a reasonable accommodation in rules, policies, practices, or services, (“practices”) when such accommodations may be necessary to afford persons with disabilities an equal opportunity to use and enjoy the housing. If you have a reasonable accommodation request related to this application/Certification, please describe it below. If you have any other requests, including a reasonable accommodation request related to the Owner/Developer’s practices, or a reasonable modification request related to the physical structure of the building or unit, do not list it here. That request must be made directly to the Owner/Developer. If you have a reasonable accommodation request related to this application/Certifiation please explain in the space provided here or write a signed statement and attach it: RELATED PARTY Is any member of the household related to or employed by the developer or related to or employed by the Property Management Company? Yes No If yes, please explain the relationship in the space provided here: DATABASE INFORMATION How did you find out about this affordable housing opportunity? (please be as specific as possible, if found “online” please provide web address) ---PAGE BREAK--- 5 INSTRUCTIONS FOR COMPLETING THE FOLLOWING INCOME TABLE Please complete the Income Table on the following two pages. After the lottery, if you are given the opportunity to move forward, you will be asked to attach supporting documentation including, but not limited to, five most recent consecutive pay stubs and/or income statements for all sources of income, W-2 statements and the most recent federal income tax returns (including all attachments and amendments) for each member of the household. For the purpose of income determination, “Household” shall mean all persons whose names appear on the lease, and also all persons who intend to occupy the housing unit as their permanent primary residence, even if they are not included on the lease. Legally married couples shall both be considered part of the household, even if separated. The incomes of all household members will be included, with the exception of income from employment for household members under the age of 18 or any income over $480/year of full-time students who are dependents (but please note that documentation of income for those dependents still needs to be supplied). Please note: 1. Gross income from current wages, salaries, tips, etc. is the full amount, before any deductions, and is the amount used to determine estimated current annualized income. 2. For self-employed applicants- include the contract or job name in the space provided. You will be directed to all the additional documentation you will need to submit after the lottery. 3. “Interest Income” refers to any amount that you receive from any asset except for amounts drawn down from a retirement account or 401K as those go on the lines for “pension” or “retirement funds”. ---PAGE BREAK--- 6 INCOME Household Member Name Source of Income Current GROSS Income Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Employer (name) Self-Employed (contract/job name) Self-Employed (contract/job name) Self-Employed (contract/job name) Child Support/Alimony Child Support/Alimony Social Security Income Social Security Income Social Security Income Social Security Income SSDI SSDI Pension (list source) Pension (list source) Retirement Distributions ---PAGE BREAK--- 7 Household Member Name Source of Income Current GROSS Income Unemployment Compensation Workman’s Compensation Severance Pay Title IV/TANF Full-Time Student Income (18 & Over Only) Full-Time Student Income (18 & Over Only) Periodic payments from family/friends & Recurring Gifts (i.e. rent assistance from family) Interest Income (source) Interest Income (source) Interest Income (source) Interest Income (source) Interest Income (source) Interest Income (source) Other Income (name/source) Other Income (name/source) Gross Household Income (GMHI) $ /month GMHI x 12 = Gross Annual Household Income $ /year ---PAGE BREAK--- 8 ASSETS If a section doesn’t apply, cross out or write N/A. After the lottery you will be directed to submit detailed bank/balance statements for EVERY ASSET listed here. If any household member has divested themselves of an asset for less than full and fair present cash value of the asset within two years prior to this application, the full and fair cash value of the asset at the time of its disposition must be listed below. Checking Accounts Bank Name Last 4 Digits of Acct Number Amount Balance $ Balance $ Balance $ Balance $ Savings Accounts Balance $ Balance $ Balance $ Balance $ Trust Account Balance $ Venmo/Paypal /Cash-App Balance $ Balance $ Certificates (or CDs) Balance $ Balance $ Balance $ Savings Bonds Maturity Date: Value $ Maturity Date: Value $ 401k, IRA, Retirement Accounts (Net Cash Value) Company Name: Value $ Company Name: Value $ Company Name: Value $ Company Name: Value $ Mutual Funds Name: # of Shares: Interest/ Dividends Value $ $ $ $ $ $ Stocks $ $ $ $ $ $ Bonds $ $ $ $ Investment Land (not a home) Current Net Equity $ You MUST complete this section on Real Estate too! Do you, or anyone on this application, currently own a home (including an investment home) or are listed on the deed for any home? □Yes □No If YES, put the current equity or the amount you should receive from the settlement here: $ ---PAGE BREAK--- 9 You must now read, sign, and date the next page. And please do not staple your supporting documentation when submitting it. ---PAGE BREAK--- 10 Please read each item below carefully before you sign. 1. I hereby declare under pain and penalty of perjury that the information provided on every page of this application is true and correct. I understand that if any sources of income or assets are not disclosed on this application, or any information provided herein is not true and accurate, this application may be removed immediately from further consideration and I will no longer be allowed to reserve a unit. 2. I understand that this application will be incomplete if I do not sign and date this page and initial at all indicated points in the application. 3. The undersigned certify that none of the people listed in this application, or their families, have a financial interest in the development and none of the people listed in this application can be considered a Related Party by the affordable housing guidelines that govern this property. 4. The undersigned certify that the affordable unit will be undersigned’s principal residence and the undersigned cannot own a home elsewhere or in trust while living in an affordable unit. 5. I understand that the lease or residency agreement for the units to be occupied through this affordable housing program may be subject to cancellation if any of the information above is not true and accurate. 6. I understand that this is a preliminary application and the information provided does not guarantee housing. 7. I understand this is not a lease application and if given the opportunity to move forward in the process of leasing an affordable unit, and by given deadlines I will need to complete Program Certification and a lease application where my affordable housing program and lease eligibility will be determined by additional factors such as credit score, tenant history and criminal background screening. I understand that if selected high enough in the lottery to move forward, I will need to be able to submit all required income, asset, tax and if applicable, local preference, accesible, vision-impaired, and/or hearing-impaired documentation within 10 days of the lottery deadline and failure to submit the required documentation in time, or to meet any other deadlines given by SEB or the management company, will result in my removal from the Waiting List. 8. I understand that any material change in the income or assets of my household, or my household composition, that occurs after the submission of this application may make me ineligible for affordable housing. I understand that any changes to income or assets that may put my household into another income tier must be reported to SEB. 9. Co-signers and Guarantors are not permitted unless they are co-tenants who will reside in the unit. 10. I acknowledge that if my email address is provided in this application, SEB will correspond with me by email instead of postal mail unless I make a written request otherwise. I understand that any changes to my contact information must be reported to SEB. 11. I acknowledge that the determination of eligibility by SEB Housing is based upon the guidelines that govern the Affordable Housing Program for the development and, as such, barring any confirmed error by SEB Housing in applying the guidelines and/or calculating income, the decision is final and I further agree to hold harmless SEB Housing from any claim(s) related to this application. 12. The undersigned give consent to the City of Beverly, SEB Housing LLC, EOHLC, and the Property Management Company to verify the information provided in this application. The undersigned authorize the release of information necessary in determining income and assets from third-party references. Applicant’s Signature Date Send applications by the date on the cover page to SEB (DO NOT SEND THEM TO THE PROPERTY, SEND THEM TO THE NEEDHAM ADDRESS). For Questions contact [EMAIL REDACTED] or (617) 782-6900 This development does not discriminate in the selection of applicants on the basis of race, color, national origin, disability, age, ancestry, children, familial status, genetic information, marital status, public assistance recipiency, religion, sex, sexual orientation, gender identity, veteran/military status, or any other basis prohibited by law