Write N/A if an item does not apply. Do not provide medical records or details about a disability on this form.

List every person who will live in the unit. Each adult may be required to complete screening authorization.

List all lawful income you want considered: employment, self-employment, pension, Social Security, SSI or SSDI, VA benefits, child support, alimony, or other verifiable sources.

A request for a reasonable accommodation may be made separately. Do not state a diagnosis or provide medical details here. Service and assistance animals are not treated as pets where applicable law requires.

A Yes answer does not automatically result in denial. Veterans Landing evaluates information under its written screening standards and applicable law.

This section supports program coordination and is separate from ordinary rental screening. Do not include medical information.

Do not identify a disability or describe medical details on this application. Management will provide a separate process when supporting information is needed.

I certify that the information in this application is true, complete, and correct to the best of my knowledge. I understand that material false statements or omissions may be grounds for denial or, if discovered after move-in, action permitted by the lease and law. I authorize Veterans Landing and its agents to verify information relevant to tenancy, including identity, rental history, income, employment, rental assistance, references, and public records, and to obtain consumer reports only after any legally required notice and authorization. I authorize the persons and organizations identified in this application to release relevant verification information. This authorization does not permit release of medical records. I understand that Veterans Landing may request additional documentation and that this application is not a lease or promise of housing.