Housing Application | Ivery Fresh Start Ho

First name

Last name

Email

Address

Number of Adults in Household

Number of Children in Household

Total Monthly Household Income

Primary Source of Income

Maximum Monthly Rent Budget

Preferred City / Area

Bedrooms Needed

Desired Move-In Date

Month

Day

Year

Which property are you interested in?

Is your gross monthly household income at least 3× your expected monthly rent?

Yes

No

Not Sure

Have you had an eviction?

Yes

No

Do you currently owe money to a previous landlord or property management company?

Yes

No

Not Sure

Do you have pets?

Yes

No

Please tell us about your housing situation and any circumstances you would like us to consider.

Can you provide documentation verifying your household income?

Yes

No

Not Sure

Do you have a previous landlord or rental reference we may contact?

Yes

No

Is there anything else you would like us to know about your housing needs?

I understand that submitting this inquiry does not guarantee housing, approval, or placement. Participating property owners establish their own lawful screening criteria and make all final rental decisions.

I certify that the information I have provided is true and accurate to the best of my knowledge.

I authorize Ivery Fresh Start Housing Network Corporation to contact me regarding my housing inquiry and potential housing opportunities.

I authorize Ivery Fresh Start Housing Network Corporation to share relevant information from my housing inquiry with participating property owners when necessary to explore a potential housing opportunity.