1 LTD MANAGEMENT Select Property Senior Residence    Astoria Senior Residence,21-05 30th Drive, Astoria, NY    Bayshore senior Residence,57 Park Avenue, Bay shore, NY    Calvary Grandparent residence,162-25 112th Road, Jamaica, NY    halletts cove Senior Residence,14-20 27th Avenue Astoria, NY    Dekalb Senior Residence,1251 Dekalb Avenue Brooklyn, NY    The Summerset at Locust Manor (senior),170-06 Baisley Boulevard Rochdale, NY    Macedonia Senior Residence,333 Beach 67thStreet, Arverne, NY Multi Family Residence    Brooke pointe at valley stream,100 Gibson Ave, Valley Stream, NY    Gleneagle green residence,BELL PORT, NY    Highland green residence,Melville, NY    linden knolls residence,261 South Franklin Street, Hempstead, NY    Parkside Garden Villas,75 Laurel Avenue Hempstead, NY    The Arbor,169-30 Baisley Boulevard, Jamaica, NY    The Eclipse at Locust Manor,126-30 Locust Manor Lane, Jamaica, NY    The Horizon at Locust Manor,126-02 Locust Manor Lane, Jamaica, NY    The Meridian at Locust Manor,127-10 Locust Manor Lane, Jamaica, NY Property Name: Property Address: MAIL COMPLETED APPLICATION TO: 100 SCHOOLHOUSE ROAD, LEVITTOWN, NY 11756 **Non- Smoking Building/ No Pets Allowed WARNING: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements of misrepresentations of any material facts involving the use or obtaining federal funds.

2 Applications are placed in order of date and time received. An applicant may be interviewed only after the receipt of this tenant application. A. GENERAL INFORMATION Applicant Name(s): Address: Street Apt. # City State ZIP Daytime Phone: Email: No. of BR’s in Current unit: Do you RENT or OWN (check one) Amount of current monthly rental or mortgage payment: $ If owned, do you receive monthly rental income from property? YES NO (check one) Check utilities paid by you: Heat Electricity Gas Other (specify) Approximate monthly cost of utilities paid by you (excluding phone and cable TV): $ Bedroom size requested: Studio One BR Two BR Three BR Handicap BR Check all that apply: Veteran Mobility Impaired Hearing Impaired Visually Impaired Does any member of the household hold a housing voucher? YES NO (check one) B. HOUSEHOLD COMPOSITION Name Relationship to head Birth Date Age (optional) SS# (last 4 digits) Student Y/N Head Co-H 3. 4. 5. 6. Preferred Method of Contact: Email Mail Phone

3 Have there been any changes in household composition in the last twelve months? Yes No If yes, explain: Do you anticipate any changes in household composition in the next twelve months? Yes No If yes, explain: Will all of the persons in the household be or have been full-time students during five calendar months of this year or plan to be in the next calendar year at an educational institution (other than a correspondence school) with regular faculty and students? Yes No IF YES, ANSWER THE FOLLOWING QUESTIONS: Are any full time student(s) married and filing a joint tax return? Yes No Are any student(s) enrolled in a job-training program receiving assistance under the Job Training Partnership Act? Yes No Are any full-time student(s) a TANF of a Title IV recipient? Yes No Are any full-time student(s) a single parent living with his/her child(ren) who is not a Dependant on another’s tax return and whose children are not dependents of anyone other than a parent? Yes No C. INCOME List ALL source of income as requested below. If a section doesn’t apply, cross out or write N/A. Household Member Name Source of Income Gross Monthly Amount Social Security $ Social Security $ Social Security $ SSI Benefits $ SSI Benefits $ SSI Benefits $ Pension (list source) $ Pension (list source) $ Veteran’s Benefits (list claim #) $ Veteran’s Benefits (list claim #) $ Unemployment Compensation $ Unemployment Compensation $ Public Assistance (Title IV/TANF etc.) $ Contributions to the Household (monetary or not) $ Full-Time Student Income (18 & Over Only) $ Financial Aid (excluding loans) $ Annuities (list sources) $ Long Term Medical Care Insurance Payments in excess of $180/day $ Scheduled Payments from Investments $

4 Household Member Name Source of Income Gross Monthly Amount Employment amount $ Employer: Position Held How long employed: Employment amount $ Employer: Position Held How long employed: Employment amount $ Employer: Position Held How long employed: Employment amount $ Employer: Position Held How long employed: Alimony Are you legally entitled to receive alimony? Yes No If yes, list the amount you are entitled to receive. $ Do you receive alimony? Yes No If yes list amount you receive. $ Child Support Are you legally entitled to receive child support? Yes No If yes, list the amount you are entitled to receive. $ Do you receive child support? Yes No If yes, list the amount you receive. $ Other Income $ Other Income $ TOTAL GROSS ANNUAL INCOME (Based on the monthly amounts above x 12) $ TOTAL GROSS ANNUAL INCOME FROM PREVIOUS YEAR $ Do you anticipate any changes in this income in the next 12 months? Yes No Is any member of the household legally entitled to receive income assistance? Yes No Is any member of the household likely to receive income or assistance ( monetary or not) from someone who is not a member of the household as listed on Page 2 etc.)? Yes No If yes to any of the above, explain: Is the income received? Yes No

5 D. ASSETS If your assets are too numerous to list here, please request and additional form. If a section doesn’t apply, cross out or write N/A. Checking Accounts # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ # Bank Balance $ Savings Accounts Trust Account # Bank Balance $ Certificates of Deposit Money Market Accounts Savings Bonds # Maturity Date Value $ # Maturity Date Value $ # Maturity Date Value $ Life Insurance Policy # Cash Value $ Life Insurance Policy # Cash Value $ Mutual Funds Name: #Shares: Interest or Dividend $ Value $ Name: #Shares: Interest or Dividend $ Value $ Name: #Shares: Interest or Dividend $ Value $ Stocks Name: #Shares: Dividend Paid $ Value $ Name: #Shares: Dividend Paid $ Value $ Name: #Shares: Dividend Paid $ Value $ Bonds Name: #Shares: Interest or Dividend $ Value $ Name: #Shares: Interest or Dividend $ Value $ Investment Property Appraised Value $ Real Estate Property: Do you own any property? Yes No If yes, Type of property Location of property Appraised Market Value $ Mortgage or outstanding loans balance due $ Amount of annual insurance premium $ Amount of most recent tax bill $

6 Does any member of the household have an asset(s) owned jointly with a person who is NOT a member of the household as listed on Page 2? Yes No If yes, describe: Do they have access to the asset(s)? Yes No Have you sold/ disposed of any property in the last 2 years? Yes No If yes, Type of property: Market value when sold/ disposed $ Amount sold/ disposed for $ Date of transaction: E. ADDITIONAL INFORMATION Are you or any member of your family currently using an illegal substance? Yes No Have you or any member of your family ever been convicted of a felony? Yes No If yes, describe: Have you or any member of your family ever been evicted from any housing? Yes No If yes,describe F. VEHICLE AND PET INFORMATION (if applicable) List any cars, trucks, or other vehicles owned. Parking will be provided for one vehicle. Arrangements with Management will be necessary for more than one vehicle. Type of Vehicle: Type of Vehicle: Year/ Make/ Model: Year/ Make/ Model: Do you own any pets? Yes No If yes, describe: Have you disposed of any other assets in the last 2 years (Example: Given away money to relatives, set up Irrevocable Trust Accounts)? Yes No If yes, describe the asset: Date of disposition: Amount disposed $ Do you have any other assets not listed above (excluding personal property)? $ If yes, please list: Have you ever filed for bankruptcy? Yes No If yes, describe: How did you hear about us? Newsday World Journal El Correo Community Contact Other

7 REFERENCES Current Landlord Name: Address: Phone: How Long? Prior Landlord Name: Address: Phone: How Long? Personal Reference #1: Address: Relationship: Phone #: Personal Reference #2: Address: Relationship: Phone #: (I/WE) hereby acknowledge that (I/WE) have received the Vawa. CERTIFICATION I/We hereby certify that I/We Do/Will Not maintain a separate subsidized rental unit in another location. I/We further certify that this will be by/our permanent residence. I/We understand I/We must pay a security deposit for this apartment prior to occupancy. I/We understand that my eligibility for housing will be based on applicable income limits and by management’s criteria. I/We c ertify that all information in this application is true to the best of my/our knowledge and I/We understand that false statements or information are punishable by law and will lead to cancellation of this application or termination of tenancy after occupancy. All adult applicants, 18 or older, must sign application. SIGNATURE (S): (Signature of Tenant) Date (Signature of Co-Tenant) Date (Signature of Co-Tenant) Date (Signature of Co-Tenant) Date In case of emergency notify: Address: Relationship: Phone #:

8 TENANT DATA VERIFICATION AUTHORIZATION TO OBTAIN A CREDIT REPORT/CRIMINAL L&T COURT RECORD APARTMENT # BUILDING ADDRESS: I HEREBY AUTHORIZE ANY INDIVIDUAL, COMPANY, OR INSTITUTION TO RELEASE TO AND OR ITS REPRESENTATIVE ANY AND ALL INFORMATION THAT THEY HAVE CONCERNING CREDIT REPORT ANY CRIMINAL ACTIVITY AND LANDLORD/TENANT COURT RECORDS… I HEREBY RELEASE THE INDIVIDUAL, COMPANY, OR INSTITUTION AND ALL INDIVIDUALS, CONNECTED THEREWITH FROM ALL LIABILITY FOR ANY DAMAGE WHATSOEVER INCURRED IN FURNISHING SUCH INFORMATION…. Print Name: Signature: Social Security #: Date of Birth: Address:

9 Tenant Screening Report Disclosure Statement By signing below, I confirm that I have been made aware of, and understand all of the following information related to my application, and the consumer reports, tenant screening reports, investigative reports, criminal background search, OFAC watch list search, sex offender registry searches, employment, banking and tenancy verifications and any other searches that may be conducted in connection with my application. 1. The information provided by me on my application will be used to obtain a tenant screening report, also known as a consumer report, and other such searches as listed above. 2. The tenant screening report will be obtained from one or more of the following sources: a. Experian, P.O. Box 954, Allen, Texas 75013 www.experian.com 888-397-3742. b. Equifax P.O. Box 740256, Atlanta, Georgia 30374 www.equifax.com877-576-5734 c. Trans Union P.O. Box 6790, Fullerton CA 92834 www.transunion.com 800-680- 7289 d. First Advantage Saferent/Core Logic Safe Rent 7300 Westmore Road Suite 3 Rockville, MD 20850-5223. 888-333-2413 e. Fidelity Information Corporation, P.O. Box 49938, Los Angeles, CA 90049-0978 800-50-8085. I also understand that I have the right to inspect and receive one free copy of the report by contacting the Consumer Reporting Agency that was used to furnish the report. I further understand that I may obtain a free report from each of the 3 nation consumer reporting agencies (Experian, Equifax, and Trans Union) once annually either directly from them, or through www.annualcreditreport.comand that I have the right to dispute any inaccurate information with them. Signature Date Print Name

10 TENANT DATA VERIFICATION AUTHORIZATION TO OBTAIN A CREDIT REPORT/CRIMINAL L&T COURT RECORD APARTMENT # BUILDING ADDRESS: I HEREBY AUTHORIZE ANY INDIVIDUAL, COMPANY, OR INSTITUTION TO RELEASE TO AND OR ITS REPRESENTATIVE ANY AND ALL INFORMATION THAT THEY HAVE CONCERNING CREDIT REPORT ANY CRIMINAL ACTIVITY AND LANDLORD/TENANT COURT RECORDS… I HEREBY RELEASE THE INDIVIDUAL, COMPANY, OR INSTITUTION AND ALL INDIVIDUALS, CONNECTED THEREWITH FROM ALL LIABILITY FOR ANY DAMAGE WHATSOEVER INCURRED IN FURNISHING SUCH INFORMATION…. Print Name: Signature: Social Security #: Date of Birth: Address:

11 Tenant Screening Report Disclosure Statement By signing below, I confirm that I have been made aware of, and understand all of the following information related to my application, and the consumer reports, tenant screening reports, investigative reports, criminal background search, OFAC watch list search, sex offender registry searches, employment, banking and tenancy verifications and any other searches that may be conducted in connection with my application. 1. The information provided by me on my application will be used to obtain a tenant screening report, also known as a consumer report, and other such searches as listed above. 2. The tenant screening report will be obtained from one or more of the following sources: a. Experian, P.O. Box 954, Allen, Texas 75013 www.experian.com 888-397-3742. b. Equifax P.O. Box 740256, Atlanta, Georgia 30374 www.equifax.com877-576-5734 c. Trans Union P.O. Box 6790, Fullerton CA 92834 www.transunion.com 800-680- 7289 d. First Advantage Saferent/Core Logic Safe Rent 7300 Westmore Road Suite 3 Rockville, MD 20850-5223. 888-333-2413 e. Fidelity Information Corporation, P.O. Box 49938, Los Angeles, CA 90049-0978 800-50-8085. I also understand that I have the right to inspect and receive one free copy of the report by contacting the Consumer Reporting Agency that was used to furnish the report. I further understand that I may obtain a free report from each of the 3 nation consumer reporting agencies (Experian, Equifax, and Trans Union) once annually either directly from them, or through www.annualcreditreport.comand that I have the right to dispute any inaccurate information with them. Signature Date Print Name

12 AUTHORIZATION OF RELEASE OF INFORMATION All household members 18 years-old and over must sign authorization AUTHORIZATION AND CONSENT For myself, the undersigned, and for the minor children in my care, I hereby authorize, direct and consent to the release of any information known by any federal, state, or local agency, organization, business, or individual to LTD MANAGEMENT which is necessary to complete and verify my application or recertification for occupancy. I understand that information obtained pursuant to this authorization may be used by LTD MANAGEMENT in administering and enforcing its rules and policies. INFORMATION COVERED I understand that pursuant to this authorization, LTD MANAGEMENT may request information which includes but is not limited to my sources of personal and business income, social security numbers and my past record as a tenant. Further, I understand that such information regarding household members included on my application or recertification may be requested. I understand that this authorization cannot be used to obtain information not relevant to my application or recertification. INFORMATION SOURCES The sources that may be asked to release information may include but are not limited to my present employer, previous landlord, public agencies which administer welfare, unemployment, Social Security, and assistance to veterans, schools, and personal references. CONDITIONS I agree that a photocopy of this authorization may be used for the purposes stated above. The original of this authorization will be included in my file at LTD MANAGEMENT and will have full effect for a year and one month from the date below. Printed Name Signature Printed Name Signature Date