Silver Sage Court an affordable housing property of 16 one-bedroom units. They are
specifically designated for very low income families who are elderly and/or disabled.
These homes are available only to families whose income does not exceed 50% of the
Area Median Income (AMI) and whose income or assistance is enough to pay the rent
without hardship.
Upper income limit:
To qualify for this program, your family’s yearly income cannot exceed these FY 2015
Area Median Income (AMI) limits for your family size.
Low (50%) 1 Person 2 people 3 people 4 people 5 people 6 people 7 people 8 people
income $22,250 $25,400 $28,600 $31,750 $34,300 $36,850 $39,400 $41,950
limits
Does your family’s income exceed 50% AMI? Yes No
Lower income limit:
To qualify for this program, your family’s monthly income must be at least 2.5 times the
property’s monthly rent.
For example, if the property you would like to rent is $495 per month, your income
could be no less than 2.5 x $495, or $1,238 per month.
If you believe you qualify for Silver Sage Court housing, please complete the
application below. Applications are open to the public as well as current Section 8
recipients.
Date: Tenant I.D.
Name: Telephone:
Address: Work Telephone:
Does anyone in your household smoke? No Yes
Have you ever been arrested for any drug related or violent criminal activity? No Yes
If yes, explain:
Name FAMILY COMPOSITION Sex Race Ethnicity
Age Birth Date Relationship Social Security #
Anticipated changes in family composition:
Codes for RACE, and ETHNICITY (if applicable)
RACE: 1 - White 2 – Black or African American 3 - Asian 4 - Native Hawaiian or Other Pacific Islander 5 - American Indian or
Alaska Native 6 – American Indian or Alaska Native and White 7 – Asian and White 8 – Black or African American and White 9
American Indian or Alaska Native and Black or African American 10 – Other multi-racial
ETHNICITY: 1 - Hispanic 2 - Non-Hispanic
PERSON TO CONTACT IN CASE OF AN EMERGENCY
Name: Relationship:
Address: Telephone:
Work Telephone:
Silver Sage Application
LANDLORD INFORMATION (list past two years)
Previous Landlord Name Address Phone # From (date) To (date) RHA use only
Present Employer Name: EMPLOYMENT RECORD - Applicant
Address:
Gross Annual Income: $
Previous Employer Name:
Address: From: To:
Previous Employer Name: Gross Annual Income: $
Address:
From: To:
Present Employer Name:
Address: Gross Annual Income: $
Previous Employer Name: From: To:
Address:
EMPLOYMENT RECORD - Co-Applicant
Previous Employer Name:
Address: Gross Annual Income: $
Gross Annual Income: $
Gross Annual Income: $
Silver Sage Application
Describe: OTHER INCOME
(Child Support, Alimony, Assets)
Gross Annual Income: $
Describe: Gross Annual Income: $
Describe: Gross Annual Income: $
CHECKING ACCOUNT Bank: ASSETS Balance: $
Address:
Account Number:
SAVINGS ACCOUNT Bank: Account Number: Balance: $
Address:
STOCKS OR BONDS (including U.S. Savings Bonds) Type Amount $
Name: Original Purchase Price: $_________ Equity: $
Less unpaid balance: $_________ $
REAL ESTATE OWNED Description:
OTHER ASSETS: (Describe)
CREDIT REFERENCES
(List any bank or auto loans, credit cards, retail accounts, etc.)
Applicant or Bank or company name and address Type Account #
Co-Applicant
The Housing Authority reserves the right to complete a credit and/or criminal history check
as well as obtain verification of the information provided herein.
I certify that all information contained herein is true, complete and correct to the best of my knowledge. Failure
to provide accurate information could be cause for eviction.
Silver Sage Application
Non-Smoking Policy Agreement
To be signed by applicants for residency at Silver Sage
RHA will lease nonsmoking units only to nonsmokers or to smokers who will not smoke inside
the unit or within 20 feet of the unit. Neither tenants nor their guests may smoke in the
designated non-smoking areas. RHA will only rent to tenants who are non-smokers or will
commit to adhere to the guidelines in place for designated non-smoking buildings and refrain
from smoking within the building or within 20 feet of the building.
With this policy now in place, applicants for RHA owned properties are required to sign the
“Non-Smoking Policy Agreement”. This agreement will become part of their permanent file. If
you have any questions, please contact the property manager. Thank you.
I have been informed that, if I become a resident in a nonsmoking RHA unit,
neither I nor my guests may smoke in the building or within 20 feet of the
building.
I also understand that I am responsible for informing any guests that they may
not smoke in the building or within 20 feet of the building.
I acknowledge that any violations of this policy by either members of my
household or any guests can result in the Authority terminating my lease.
___________________________________ ______________________
Head of Household Signature Date
Silver Sage Application
Authorization for the
Release of Information
HA requesting release of information: This form cannot be used to request a copy of a tax
return. Instead, use IRS form 4506, Request for a Copy
Reno Housing Authority of Tax Form.
1525 E 9th St
Reno NV 89512-3012
(775) 329-3630 Fax# (775) 786-1712
La Autoridad de Viviendas de Reno se ha comprometido a ofrecer accesibilidad a sus programas y actividades para todos los clientes
elegibles, inclusive para aquellas personas limitadas en sus habilidades del manejo del idioma Ingles. Por favor informe a nuestro personal si
requiere otra forma diferente de comunicación que no sea verbal o por escrito en ingles.
Purpose: To verify household income. In signing this consent form, you and each member of your household who
is 18 years of age or older are authorizing Reno Housing Authority to obtain income and expense information from
sources as indicated below. This is to ensure that you are eligible for assisted housing benefits, and that these
benefits are set at the correct level.
Employment Child support Retirement Benefits
Medical/ Prescription expenses Family support contributions Student Status
Insurance company Veterans Administration Previous Housing
Child Care Utility information from supplier Stocks & Bonds
Computer Matching Notice & Consent: I understand that Reno Housing Authority may conduct computer-matching
programs with other agencies, including federal, state, tribal or local agencies including, but not limited to:
U.S. Postal Service Welfare and food stamp agencies
U.S. Department of Defense Employment Security
The match will be used to verify information supplied by my family.
Public Records Law: I understand and acknowledge that the Housing Authority of the City of Reno is a municipal
corporation and the records maintained by it as a public agency are public records subject to inspection pursuant to
NRS 239.010. Reno Housing Authority is required to protect the information it obtains in accordance with any
applicable Nevada State privacy laws.
Conditions: I/we agree that photocopies of this authorization may be used for the purposes stated above.
SIGNATURES: _ Date
(Print Name) Date
Head of Household Date
Spouse (Print Name) Date
Adult Member
Adult Member (Print Name) Silver Sage Application
Original is retained by the requesting organization (Print Name)
Criminal History Check
Requested by: Reno Housing Authority Date:
File Number: Dept:
Outstanding Warrant
Contact RPD if in office
NAME: Last PLEASE PRINT CLEARLY MI
First Female
Drivers License / ID #: State
Physical Description (hair, eyes, height, weight, approx. age, etc.):
CLEAR / NO RECORD WITH RPD
MAY REQUIRE FINGERPRINTS
I hereby give authorization to allow the Housing Authority to investigate criminal records of all family
members over 18 years of age that reside/will reside in the household.
Silver Sage Application