Project-Based Section 8 Pre-Application Form

All forms must be submitted to MBHP in ENGLISH. To fill out this form in another language, follow these instructions.
Print

Section 8
Project-Based Voucher Program

Pre-Application for housing assistance
Please complete and return to:
Metropolitan Boston Housing Partnership 125 Lincoln Street Boston, MA 02111-2503 (617)859-0400
For agency use only: Date/Time Stamp/ Control Number
Please print neatly in ink. All fields are required. Submit this form only. Incomplete, photocopied, e-mailed or faxed applications will not be accepted. If you are already on our tenant-based Section 8 waiting list your record will be updated using the information that you provide below. Due to the volume of applications received, we will not verify the receipt of mailed applications. We cannot be responsible for material that is illegible or missing as a result of transmitting by fax or e-mail or lost/delayed through the mail.

IMPORTANT!

One-third of all applicants are dropped from the waiting list due to unreported address changes. Do not let this happen to you. Report any change of address in writing to the agency listed above.

Head of Household Information

Social Security Number
Phone (include area code)
First name
Middle name
Last name
Address
City/ Town
State
Zip Code
Shelter Name
Shelter Address
City/ Town
State
Zip Code
Family Information
Write in the approximate amount of your family’s gross (before taxes) annual income. Include all sources for all family members.
Gross annual houshold income $
List the Head of Household and all other members who will be living in the unit. Give the relationship of each family member to the head. For example: spouse/partner, son, daughter, aunt, grandmother, etc....
First Name Last Name Relation to Head Birth Date Age Sex Social Security Number
If you have more than eight family members, please check here and list them on a separate piece of paper.
For Agency Use Only. Number of Household Members
Household Bedroom Size:Single1BR2BR3BR4BR5BR
Check if the head of household or spouse is:62 years old or olderDisabled
Check if anyone in the household requires a wheelchair accessible unit
We collect data on race & ethnicity in accordance with federal regulations. People of various races may also be of Hispanic ethnicity. Please indicate if you are Hispanic. Your answers will not affect your application.
Race of head of household (You may choose more than one of the following)
White Black/African American American Indian/Alaskan Native Asian Native Hawaiian/Other Pacific Islander
Ethnicity of head of household (Check only one) Hispanic Non-Hispanic
What is your current housing situation? (Check only one box)
I am homeless
I live in substandard housing
I have been involuntarily displaced by fire, flood, or other natural disaster I pay more than 50% of my monthly income for rent and utilities
I live in a shelter
I am doubled up with friends or relatives
I live in public housing
I live in a transitional housing program
I live in subsidized housing
Other (describe)
TURN PAGE OVER – APPLICATION CONTINUED ON REVERSE
5/22//13(18)
Location of Project-Based Apartments
From the list below, check the box next to the communities where you would like to live. Please do not choose a community unless you think you would really live there. Only check properties that have apartments appropriate for your household size. If you select a property from the list below that you are not eligible to occupy you will not be added to that waiting list. The housing agency will make the final determination of eligibility based on the family information that you are providing in this pre-application. If you need a larger apartment as a reasonable accommodation for a disability please contact the agency listed above for assistance in completing this form.
Single Room Occupancy (SRO) and Enhanced Single Room Occupancy (ESRO) units are only for one person. SRO units typically have shared bathrooms and may have not have a kitchen or have a shared kitchen. ESRO units have private bathrooms and may have kitchenettes. If you are a single person household and are not elderly or disabled you may only choose properties that have SRO and ESRO units. Studio apartments do not have a separate bedroom but have a full kitchen. Elderly apartments are for persons over 62 years of age. Supportive Service apartments provide certain services to tenants and you must have a documented need for the supportive services offered at these properties. Properties that have wheelchair accessible apartments are marked with the logo - contact us for more information on the available bedroom sizes of these apartments.
NOTE: Effective June 5, 2009, any projects listed below that are highlighted in yellow are temporarily closed to new applicants, until further notice.
Comunity Property/Street Number of Units by bedroom size
Elderly Only Supportive Services SRO ESRO Studio 1
BR
2
BR
3
BR
4
BR
Allston 1201 Comm. Ave 6

Arlington

Capitol Square Apts.

  2 6

Arlington

Russell Terrace

2

Arlington

Summer, Broadway, Bow and Webster

  3 1

Bedford

447 Concord Road

  3 2

Boston

1740 Washington St.

8

Boston

Boston YWCA   15 3 2

Cambridge*

Putnam Green

  2 4 2

Charlestown

Zelma Lacey

X X   15 5

Chelsea*

Highland Terrace

  1 4 3

Chelsea

Janus Highlands

  2 5 1

Chelsea

TILL Building

  3 2

Chelsea*

Spencer Green
113 Spencer Ave

  2 2 4

Chelsea*

Spencer Row
205-221 Spencer Ave

  1 4 3

Chelsea*

Harbor Cove
63 Washington Ave.

X   3 16 5

Dorchester*

Hearth at Olmstead preference Green (Kingbird Rd.)

preference   15

Dorchester

1129 Dorchester Ave.   6 1 1

Dorchester

14-24 Roach St.

  3 5

Dorchester

1285 -1291 Mass Ave

  1 3

Everett

19 Hancock St.

  3

Jamaica Pl.

82 Green St.

  10

Medford

4-6 Ashland St.

  3

Mission Hill

Doe House

  4 1

Newton

Pelham House

X   3

Quincy

6 Fort St

  1 6 1

Quincy

The Moorings

X   30 9

Quincy*

Granite St Housing

  3 2

Quincy

Winter Gardens

  2 3 1

Roxbury*

Grandfamilies House

  5 3

Roxbury*

Familias Unidas

X   6 1 1

Roxbury

430-436 Dudley St.

  3

Roxbury

28 Mt. Pleasant St.

  2

Roxbury

25 Ruggles St.

X X   35

Roxbury

10 & 20 Amory Ave.

  7 3

Somerville*

75 Cross Street

X   2 6

Somerville

109 Gilman St.

  1

Somerville

32 Kent St.

  2 6

Somerville*

St. Polycarp Apts.- Phase I

  2 3 3

Somerville*

St. Polycarp Apts.- Phase II

  2 4 2

Wakefield

48 Water St.

  6

Watertown*

1060 Belmont Street

  2 5

Watertown

Coolidge School Apts

X   4

Watertown

Marshall Place Apts X   8
*Applicants meeting a specific preference will be selected first. You will be mailed information on how to qualify for a preference.
5/22/13(18)
This housing list is updated periodically. For information on the availability of new apartments or on apartments in other parts of the state call the number at the top of this form or visit the Housing Consumer Education Center website at www.masshousinginfo.org

Certification of Applicant

Please read this statement very carefully. By signing, you are agreeing to its terms.
I hereby certify that the information I have provided in this pre-application is true and accurate. I understand that:
✔any misrepresentation or false information will result in my application being cancelled or denied, or in termination of housing assistance;
✔this is a pre-application for project-based rental assistance through DHCD and its regional administering agencies and is not an offer of housing;
✔at the time I rise to the top of the waiting lists, I will be required to provide verification of the information I have provided here, in accordance with federal housing regulations and DHCD policy;
✔it is my responsibility to notify any one of DHCD’s regional administering agencies in writing of any change of address and my application may be cancelled if I fail to do so;
✔it is my responsibility to notify any one of DHCD’s regional administering agencies in writing of any change in family size or composition that might affect the number of bedrooms my family requires and my failure to do so may affect my place on the waiting list;
✔my participation in the Section 8 housing program is subject to my being eligible and in compliance with HUD and DHCD regulations; and that I will be subject to a criminal history check.
I agree that DHCD can share my information with other state agencies for the purposes of determining program eligibility.


Signature of head of household Date
5/22/13(18)
Print
© Copyright 2014 MBHP (MBHP). All rights reserved.