Pre-Application for Affordable Housing UNPHC: Pre-Application for Affordable Housing Please indicate how you heard about us or the Organization that referred you to us by checking all that apply. * Internet Resident (current or former) Vendor Senior Center Homeless Shelter Valley Behavioral Health Independent Living Center House of Hope Drive By YWCA Housing Organization Friend or Relative Volunteers of America TURN Community Services Salt Lake Community Action Davis Behavioral Health Crossroads Urban Center Case Worker Religious Organization Other Other(s) Other Organization or method you heard about us. Add Remove Head of Household Information Name (First, Middle Initial, Last) * Date of Birth * (Accurate DOB Entry is Required for Eligibility Determination) Number in Household * Household Gross Income * Current Street Address * City, State & Zip * Daytime Phone * Evening Phone Email Optional Question: Marking any of the following may entitle you to higher placement on the wait list. Marking any of these will in no way affect the eligibility of your application. Please mark all that apply to all applicants listed above on your application. If you choose not to complete this data check this box. Please mark all that apply to all applicants listed above on your application. Homeless Physically Disability Mentally Ill Near Homeless Developmentally Disabled Person with Aids Older Persons Age 55 & Older Older Persons Age 62 & Older Other Other Type of Disability Not Listed Accessible Unit Required Other Other Type of Disability Not Listed Additionally, for NON-HUD Properties, if any of the following apply, you may be eligible for a preference over all others on the wait list. Please mark all that apply and be prepared to provide documentation. In Jeopardy of Losing Housing Voucher due to no fault of your own. Victim of Domestic Violence and in imminent danger. Victim of Human Trafficking and in imminent danger. Please answer the following questions considering each member of the household. Are you or any other household member subject to any (including lifetime) state sex offender registration program in any state? If yes, who? * Yes No If yes, who? Signature Clause I certify that to the best of my knowledge all above information is true and correct. I understand that providing false information or making false statements may be grounds for denial of my pre-application. I understand that this 'Pre-Application' is only for placement on my selected waitlist(s) and that I/we must complete a full 'Application' when I am contacted by a UNPHC Representative. In addition, my/our occupancy is contingent on meeting management's resident selection criteria and program requirements. Signature * Clear Date * Pre-Application Submittal Checklist (Selection Required) Please mark all properties below that you would like to be added to their waitlist and feel you would qualify based on age and household size. If you submit your application to the Corporate Office without this page being completed, your application will be rejected. It is your responsibility to notify each property you have marked below of any changes to your Pre-Application. Make sure you DOWNLOAD and PRINT a copy of this Pre-Application and Checklist for your records. Tax Credit = Set Amount of Rent | HUD = Rent is Approx. 30% of Gross Income | Market = Set Amount of Rent NORTH PROPERTIES (Layton, Clearfield, Ogden, Brigham City, Logan, Tremonton) Age 55 & Older Properties Age 55 & Older Properties Age 55 & Older Properties Street Address # Bdrms Program WOODLANDS WOODLANDS WOODLANDS 41 East 900 South, Brigham City 1 & 2 Bedrooms: 1 & 2 Tax Credit Program: Tax Credit Age 62 & Older Properties Age 62 & Older Properties Age 62 & Older Properties Street Address # Bdrms Program HOLLY HAVEN HOLLY HAVEN HOLLY HAVEN 1100 South 1000 East, Clearfield 1 Bedrooms: 1 HUD Program: HUD VILLAGE SQUARE I & II VILLAGE SQUARE I & II VILLAGE SQUARE I & II 600 East 6th Street, Ogden 1 Bedrooms: 1 HUD Program: HUD BRIGHAM CITY SENIOR BRIGHAM CITY SENIOR BRIGHAM CITY SENIOR 367 North Main, Brigham City 1 Bedrooms: 1 HUD Program: HUD CARL INOWAY CARL INOWAY CARL INOWAY 690 South Riverwalk Parkway, Logan 1 Bedrooms: 1 HUD Program: HUD SPRING HOLLOW SPRING HOLLOW SPRING HOLLOW 1360 North 200 East, Logan 1 Bedrooms: 1 HUD Program: HUD RIVERVIEW APARTMENTS RIVERVIEW APARTMENTS RIVERVIEW APARTMENTS 135 South 100 East, Tremonton 1 Bedrooms: 1 HUD Program: HUD Individual & Family Properties Individual & Family Properties Individual & Family Properties Street Address # Bdrms Program ELMHURST/McGREGOR ELMHURST/McGREGOR ELMHURST/McGREGOR 810 25th Street, Ogden Studio,1, 2, 3 & 4 Bedrooms: Studio,1, 2, 3 & 4 Tax Credit Program: Tax Credit HOLLY HAVEN HOLLY HAVEN HOLLY HAVEN 1100 South 1000 East, Clearfield 1 & 2 Bedrooms: 1 & 2 HUD Program: HUD BEAR RIVER VALLEY BEAR RIVER VALLEY BEAR RIVER VALLEY 767 West 600 South, Tremonton 1 & 2 Bedrooms: 1 & 2 RD/Tax Credit Program: RD/Tax Credit SNOW CREEK APARTMENTS SNOW CREEK APARTMENTS SNOW CREEK APARTMENTS 221 North Fairfield Road, Layton 2 & 3 Bedrooms: 2 & 3 HUD Program: HUD SALT LAKE AREA PROPERTIES Age 55 & Older Properties Age 55 & Older Properties Age 55 & Older Properties Street Address # Bdrms Program ESCALANTE PARK II ESCALANTE PARK II ESCALANTE PARK II 1660 West 1000 North, SLC 1 Bedrooms: 1 Tax Credit Program: Tax Credit LOWELL APARTMENTS LOWELL APARTMENTS LOWELL APARTMENTS 756 South 200 East, SLC 1 Bedrooms: 1 Tax Credit Program: Tax Credit JAMES E KIER (Liberty Wells) JAMES E KIER (Liberty Wells) JAMES E KIER (Liberty Wells) 260 East 800 South, SLC 1 & 2 Bedrooms: 1 & 2 Tax Credit Program: Tax Credit THE GARDEN THE GARDEN THE GARDEN 10850 South Beckstead Lane, South Jordan 1 & 2 Bedrooms: 1 & 2 Tax Credit Program: Tax Credit WEST JORDAN II (Jordan Valley) WEST JORDAN II (Jordan Valley) WEST JORDAN II (Jordan Valley) 7832 South 3200 West, West Jordan 1 & 2 Bedrooms: 1 & 2 Tax Credit Program: Tax Credit Age 62 & Older Properties Age 62 & Older Properties Age 62 & Older Properties Street Address # Bdrms Program ESCALANTE PARK I & III ESCALANTE PARK I & III ESCALANTE PARK I & III 1040 North Redwood Road, SLC 1 Bedrooms: 1 HUD Program: HUD GLENDALE GLENDALE GLENDALE 1239 South Glendale Drive, SLC 1 Bedrooms: 1 HUD Program: HUD HAMILTON PLACE HAMILTON PLACE HAMILTON PLACE 764 South 800 East, SLC 1 Bedrooms: 1 HUD Program: HUD MULTI-ETHNIC SENIOR HIGHRISE MULTI-ETHNIC SENIOR HIGHRISE MULTI-ETHNIC SENIOR HIGHRISE 120 South 200 West, SLC 1 Bedrooms: 1 HUD Program: HUD PRESTON PLACE PRESTON PLACE PRESTON PLACE 2673 South Preston (1935 East), SLC 1 Bedrooms: 1 HUD Program: HUD SHARON GARDENS SHARON GARDENS SHARON GARDENS 3354 South Sue Street, SLC 1 Bedrooms: 1 HUD Program: HUD JERALD H MERRILL JERALD H MERRILL JERALD H MERRILL 8923 West 2700 South, Magna 1 Bedrooms: 1 HUD Program: HUD MARTHA'S TERRACE MARTHA'S TERRACE MARTHA'S TERRACE 2617 South 9040 West, Magna 1 Bedrooms: 1 HUD Program: HUD PLYMOUTH VIEW PLYMOUTH VIEW PLYMOUTH VIEW 4764 Plymouth View Drive, Taylorsville 1 Bedrooms: 1 HUD Program: HUD WEST JORDAN WEST JORDAN WEST JORDAN 2105 West Sugar Factory Road, West Jordan 1 Bedrooms: 1 HUD Program: HUD DOMINGUEZ PARK LP DOMINGUEZ PARK LP DOMINGUEZ PARK LP 3990 South 700 West, SLC 1 & 2 Bedrooms: 1 & 2 HUD Program: HUD Individual & Family Properties Individual & Family Properties Individual & Family Properties Street Address # Bdrms Program ASPENVIEW ASPENVIEW ASPENVIEW 1230 East Elgin Avenue (no office), SLC Studio Bedrooms: Studio Tax Credit Program: Tax Credit SEDONA SEDONA SEDONA 562 West 200 North (no office), SLC Studio Bedrooms: Studio Tax Credit Program: Tax Credit STRATFORD APARTMENTS STRATFORD APARTMENTS STRATFORD APARTMENTS 169 East 200 South, SLC Studio Bedrooms: Studio Tax Credit Program: Tax Credit LORNA DOONE LORNA DOONE LORNA DOONE 135 South 300 East, SLC Studio & 1 Bedrooms: Studio & 1 HUD Program: HUD PETER PAN PETER PAN PETER PAN 445 East 300 South, SLC Studio & 1 Bedrooms: Studio & 1 Tax Credit Program: Tax Credit PICCARDY PICCARDY PICCARDY 115 South 300 East, SLC Studio & 1 Bedrooms: Studio & 1 Tax Credit Program: Tax Credit SMITH SOUTH APARTMENTS SMITH SOUTH APARTMENTS SMITH SOUTH APARTMENTS 682 East 700 South, SLC Studio & 1 Bedrooms: Studio & 1 Tax Credit Program: Tax Credit SOPHIE APARTMENTS SOPHIE APARTMENTS SOPHIE APARTMENTS 925 South 200 West, SLC Studio, 1 & 2 Bedrooms: Studio, 1 & 2 Tax Credit Program: Tax Credit RIVERWOOD COVE RIVERWOOD COVE RIVERWOOD COVE 582 North Riverside Drive, SLC 1 & 2 Bedrooms: 1 & 2 Tax Credit Program: Tax Credit Individual & Family Properties Individual & Family Properties Individual & Family Properties Street Address # Bdrms Program CANYON ECHO CANYON ECHO CANYON ECHO 2215 East 3300 South, SLC 2 Bedrooms: 2 Market Program: Market JUSTIN C. STEWART PLAZA JUSTIN C. STEWART PLAZA JUSTIN C. STEWART PLAZA 7986 West 3500 South, Magna 2 Bedrooms: 2 HUD Program: HUD 5TH STREET APARTMENTS 5TH STREET APARTMENTS 5TH STREET APARTMENTS 3584 South 500 East, SLC 2 & 3 Bedrooms: 2 & 3 Market Program: Market DOMINGUEZ PARK III DOMINGUEZ PARK III DOMINGUEZ PARK III 3970 South 700 West, SLC 2 & 3 Bedrooms: 2 & 3 HUD Program: HUD JACOB APARTMENTS JACOB APARTMENTS JACOB APARTMENTS 303 East 600 South, SLC 2 & 3 Bedrooms: 2 & 3 Market Program: Market JARED ALAN CAMPBELL COURT JARED ALAN CAMPBELL COURT JARED ALAN CAMPBELL COURT 1596 West 3395 South, WVC 2 & 3 Bedrooms: 2 & 3 Tax Credit Program: Tax Credit SMITH NORTH APARTMENTS SMITH NORTH APARTMENTS SMITH NORTH APARTMENTS 228 South 300 East, SLC 2 & 3 Bedrooms: 2 & 3 Tax Credit Program: Tax Credit WILLOW PARK WILLOW PARK WILLOW PARK 3746 Desert Willow Dr. (3375 W), WVC 2 & 3 Bedrooms: 2 & 3 Tax Credit Program: Tax Credit PRESERVATION DUPLEXES PRESERVATION DUPLEXES PRESERVATION DUPLEXES Multiple Locations (No Office), SLC 2, 3 & 4 Bedrooms: 2, 3 & 4 Market/HOME Program: Market/HOME OLD CHECKBOXES Age 55 & Older Properties ESCALANTE PARK II | 1660 West 1000 North, SLC | 1 bdrm | Tax Credit JAMES E KIER (Liberty Wells) | 260 East 800 South, SLC | 1 & 2 bdrm | Tax Credit LOWELL APARTMENTS | 756 South 200 East, SLC | 1 bdrm | Tax Credit THE GARDEN | 10850 South Beckstead Lane, South Jordan | 1 & 2 bdrm | Tax Credit WEST JORDAN II (Jordan Valley) | 7832 South 3200 West, West Jordan | 1 & 2 bdrm | Tax Credit WOODLANDS | 441 East 900 South Brigham City | 1 & 2 bdrm | Tax Credit Age 62 & Older Properties BRIGHAM CITY SENIOR | 367 North Main, Brigham City | 1 bdrm | HUD CARL INOWAY | 690 South Riverwalk Parkway, Logan | 1 bdrm | HUD DOMINGUEZ PARK LP | 3990 South 700 West, SLC | 1 & 2 bdrm | HUD ESCALANTE PARK I & III | 1040 North Redwood Road, SLC | 1 bdrm | HUD GLENDALE | 1239 South Glendale Drive, SLC | 1 bdrm | HUD HAMILTON PLACE | 764 South 800 East, SLC | 1 bdrm | HUD HOLLY HAVEN | 1100 South 1000 East, Clearfield | 1 bdrm | HUD JERALD H MERRILL | 8923 West 2700 South, Magna | 1 bdrm | HUD MARTHA'S TERRACE | 2617 South 9040 West, Magna | 1 bdrm | HUD MULTI-ETHNIC SENIOR HIGHRISE | 120 South 200 West, SLC | 1 bdrm | HUD PLYMOUTH VIEW | 4764 Plymouth View Drive, Taylorsville | 1 bdrm | HUD PRESTON PLACE | 2673 South Preston (1935 East), SLC | 1 bdrm | HUD RIVERVIEW APARTMENTS | 135 South 100 East, Tremonton | 1 bdrm | RD SHARON GARDENS | 3354 South Sue Street, SLC | 1 bdrm | HUD SPRING HOLLOW | 1360 North 200 East, Logan | 1 bdrm | HUD VILLAGE SQUARE I & II | 600 East 6th Street, Ogden | 1 bdrm | HUD WEST JORDAN | 2105 West Sugar Factory Road, West Jordan | 1 bdrm | HUD Family Properties 5TH STREET APARTMENTS | 3584 South 500 East, SLC | 2 & 3 bdrm | Market ASPENVIEW | 1230 East Elgin Avenue (no office), SLC | Studio | Tax Credit BEAR RIVER VALLEY | 767 West 600 South, Tremonton | 1 & 2 bdrm | RD/Tax Credit CANYON ECHO | 2215 East 3300 South, SLC | 2 bdrm | Market DOMINGUEZ PARK III | 3970 South 700 West, SLC | 2 & 3 bdrm | HUD ELMHURST/McGREGOR | 810 25th Street, Ogden | Studio,1, 2, 3 & 4 bdrm | Tax Credit HOLLY HAVEN | 1100 South 1000 East, Clearfield | 1 & 2 bdrm | HUD JACOB APARTMENTS | 303 East 600 South, SLC | 2 & 3 bdrm | Market JARED ALAN CAMPBELL COURT | 1596 West 3395 South, WVC | 2 & 3 bdrm | Tax Credit JUSTIN C. STEWART PLAZA | 7986 West 3500 South, Magna | 2 bdrm (Disabled) | HUD LORNA DOONE | 135 South 300 East, SLC | Studio & 1 bdrm | HUD PETER PAN | 445 East 300 South, SLC | Studio & 1 bdrm | Tax Credit PICACARDY | 115 South 300 East, SLC | Studio & 1 bdrm | Tax Credit PRESERVATION DUPLEXES | Multiple Locations (No Office), SLC | 2, 3 & 4 bdrm | Market/HOME RIVERWOOD COVE | 582 North Riverside Drive, SLC | 1 & 2 bdrm | Tax Credit SEDONA | 562 West 200 North (no office), SLC | Studio | Tax Credit SMITH NORTH APARTMENTS | 228 South 300 East, SLC | 2 & 3 bdrm | Tax Credit SMITH SOUTH APARTMENTS | 682 East 700 South, SLC | Studio & 1 bdrm | Tax Credit SNOW CREEK APARTMENTS | 221 North Fairfield Road, Layton | 2 & 3 bdrm | HUD SOPHIE APARTMENTS | 925 South 200 West, SLC | Studio, 1 & 2 bdrm | Tax Credit STRATFORD APARTMENTS | 169 East 200 South, SLC | Studio | Tax Credit WILLOW PARK | 3746 Desert Willow Dr. (3375 W), WVC | 2 & 3 bdrm | Tax Credit If you are human, leave this field blank. 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