Owner Application

10 OWNER APPLICATION JOHNSTON COUNTY HAPP OFFICE – HOUSING CHOICE VOUCHER PROGRAM INDIVIDUAL PROPERTY OWNERS APPLICATION Revised 01 2024 If you are a new Landlord - Please complete and submit this form in person to the Johnston County HAPP Office at 107 E Johnston St , Smithfield NC or via email at HAPP @ JohnstonNCcom False responses or misrepresentations made by the Owner Landlord in the completion of this form will constitute an automatic denial of participation in our Housing Choice Voucher Program PROPERTY ADDRESS _______________________________________________________________________ OWNER NAME First , Middle , Last __ _________________________________________________________ OWNER DATE OF BIRTH _________________ PHONE __ _____________________________ EMAIL ADDRESS __ ________________________________________________________________________ CO - OWNER NAME First , Middle , Last ________________________________________________________ CO - OWNER DATE OF BIRTH __ _____________ PHONE __ _____________________________ CO - OWNER EMAIL ADDRESS ________________________________________________________________ OWNER’S PHYSICAL ADDRESS __ _____________________________________________________________ __ ______________________________________________________________________________________ MAILING ADDRESS ________________________________________________________________________ __ ______________________________________________________________________________________ THE OWNER LANDLORD MUST ANSWER THE FOLLOWING QUESTIONS TO FACILITATE AN EVALUATION TO DETERMINE THE OWNER’S LANDLORD’S ELIGIBILITY TO PARTICIPATE IN THE JOHNSTON CO HCV PROGRAM 1 Do you or anyone with partial ownership of the rental unit have a criminal record YES ___________ NO__ _______ If so , please list dates and types of Offense _________________________________________________________________________________ 2 Has the owner landlord of the property in question ever been debarred , suspended or subject to a limited denial of participation under any HUD regulatory programs YES ___________ NO__ _______ 3 Has the owner landlord ever been convicted of fraud , bribery or any other corrupt or criminal acts in connection with any federal housing assistance programs YES ___________ NO__ _______Page4 Is the property in question pending foreclosure or tax lien status YES ___________ NO__ _______ 5 Does Owner Landlord have full or partial ownership of the property listed for participation in the housing choice voucher program FULL_ _______ PARTIAL _________ 6 Is the Owner Landlord or anyone with partial ownership related to a prospective tenant YES ______________ NO _ ___________ PLEASE READ AND INITIAL THE FOLLOWING OWNER CO - OWNER _______ __ _____ I understand that neither the Owner of the Property , nor the Landlord can be related to the Tenant Co - Tenants they choose to rent to on the HCV program _______ __ _____ I understand that Tenants are not allowed to pay “ side payments ” The HAPP Office determines their portion of rent each every time their income changes They cannot pay more than this amount This is considered fraud and could be punishable via up to a 10,000 fine and possible prison time through the HUD OIG _______ __ _____ I understand that I we cannot occupy the same location property as the property I am renting to HAPP _______ __ _____ I understand that HAPP does not allow room rentals or shared rentals _______ __ _____ I understand that payments are made via Direct Deposit and it will be up to me to keep my bank information , address , and other contact info current _______ __ _____ I understand my property must pass an Initial Inspection via HCV HUD guidelines , then be maintained in a similar condition for a follow up Annual Inspection each year ______________________________________ __ _______________________ Owner Signature Date ______________________________________ __ _______________________ Co - Owner Signature DatePage