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STATEMENTS BY OCCUPANT1. We certify that all information given in this application and any addenda thereto is true, complete and accurate. We understand that if any of this information is false, misleading or incomplete, this application may be declined or rejected, or, if we have moved in our Lease Agreement may be terminated.2. We authorize management to make any and all inquiries to verify this information, either directly or through information exchanged now or later with rental, credit, criminal screening services and to contact previous and current landlords or other sources for credit and criminal confirmation which may be released to appropriate Federal, State or local agencies.3. If our application is approved and move-in occurs, we certify that only those persons listed on this application will occupy the apartment, that they will maintain no other place of residence and that there are no other persons for whom we have or expect to have responsibility to provide housing.4. We agree to notify management in writing immediately regarding any changes in household address, telephone numbers, income and household composition.5. We have read and understand the information in this application.6. We have been notified that the Resident Selection Criteria, which summarizes the procedures for processing applications, is posted in the management and/or leasing office.7. We authorize management to obtain one or more “consumer reports” as defined in the Fair Credit Reporting Act, 15 U.S.C Section 1681 a(d), seeing information on our creditworthiness, credit standing, credit capacity, mode of living and criminal background. I understand that management is relying on the information contained in this application to prove my household’s eligibility for occupancy. I certify that all information and answers to the above questions are true and complete to the best of my knowledge. I consent to release the necessary information to determine my eligibility. I understand that providing false information or making false statements may be grounds for denial of this application. I also understand that such action may result in criminal penalties. I authorize my consent to have management verify the information contained in this application for the purposes of proving my eligibility for occupancy. I agreed to provide all necessary information, including source names, address, phone numbers and account numbers where applicable and any other information required for expediting this process.

Acknowledge & Agree

AUTHORIZATION FOR RELEASE OF INFORMATIONI hereby authorize the release to management without liability, information regarding my employment, income, and/or assets for the purposes of documenting information required under Federal and/or State housing program guidelines. Information Covered:I understand that previous or current information regarding me may be needed. Verifications and inquiries that may be requested include, but are not limited to: Personal Identity, Family Composition, Student Status, Federal Benefits, State Benefits, Local Benefits, Social Security numbers, Personal Credit, Criminal Record, Employment, Income and Assets. I understand that this authorization cannot be used to obtain any information about me that is not pertinent to my eligibility for and/or continued participation as a Qualified Resident under Federal and/or State housing program guidelines. Groups or Individuals that may be contacted: The groups, individuals or information that may be asked to release the above information include, but are not limited to:1. Current and Previous Employers2. Current and Previous Landlords3. Local, State and federal courts and law enforcement agencies4. Welfare Agencies5. State Unemployment6. Banks and other financial Institutions7. Veteran’s Administration8.Utility Companies9. Social Security Administration10. Credit Reporting Agencies11. Internal Revenue Service12. Department of Veteran’s Affairs13. Schools and Colleges14. Providers of alimony, child support, pensions, annuities. I agree that a photocopy of this authorization may be used for the purposes stated above. This authorization form expires 12 months after the date the form is signed.

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New York State Housing and Anti-Discrimination Disclosure FormFederal, State and local Fair Housing and Anti-discrimination Laws provide comprehensive protections from discrimination in housing. It is unlawful for any property owner, landlord, property manager or other person who sells, rents or leases housing, to discriminate based on certain protected characteristics, which include, but are not limited to race, creed, color, national origin, sexual orientation, gender identity or expression, military status, sex, age, disability, marital status, lawful source of income or familial status. Real estate professionals must also comply with all Fair Housing and Anti-discrimination Laws.Real estate brokers and real estate salespersons, and their employees and agents violate the Law if they:- Discriminate based on any protected characteristic when negotiating a sale, rental or lease, including representing that a property is not available when it is available.- Negotiate discriminatory terms of sale, rental or lease, such as stating a different price because of race, national origin or other protected characteristic.- Discriminate based on any protected characteristic because it is the preference of a seller or landlord.- Discriminate by “steering” which occurs when a real estate professional guides prospective buyers or renters towards or away from certain neighborhoods, locations or buildings, based on any protected characteristic.- Discriminate by “blockbusting” which occurs when a real estate professional represents that a change has occurred or may occur in future in the composition of a block, neighborhood or area, with respect to any protected characteristics, and that the change will lead to undesirable consequences for that area, such as lower property values, increase in crime, or decline in the quality of schools.- Discriminate by pressuring a client or employee to violate the Law.- Express any discrimination because of any protected characteristic by any statement, publication, advertisement, application, inquiry or any Fair Housing Law record. YOU HAVE THE RIGHT TO FILE A COMPLAINTIf you believe you have been the victim of housing discrimination you should file a complaint with the New York State Division of Human Rights (DHR). Complaints may be filed by:- Downloading a complaint form from the DHR website: www.dhr.ny.gov;- Stop by a DHR office in person, or contact one of the Division’s offices, by telephone or by mail, to obtain a complaint form and/or other assistance in filing a complaint. A list of office locations is available online at: https://dhr.ny.gov/contact-us, and the Fair Housing HOTLINE at (844)-862-8703. You may also file a complaint with the NYS Department of State, Division of Licensing Services. Complaints may be filed by:- Downloading a complaint form from the Department of State’s website https://www.dos.ny.gov/licensing/complaint_links.html- Stop by a Department’s office in person, or contact one of the Department’s offices, by telephone or by mail, to obtain a complaint form.- Call the Department at (518) 474-4429. There is no fee charged to you for these services. It is unlawful for anyone to retaliate against you for filing a complaint. For more information on Fair Housing Act rights and responsibilities please visit https://dhr.ny.gov/fairhousing and .