Ford City Motor Lofts | Rental Application

Ford City Motor Lofts

Application for Residency – Cover Letter

Dear Applicant,

Thank you for your interest in Ford City Motor Lofts managed by the Osceola Council on Aging in Salisbury, North Carolina. We are pleased to announce that the Ford City Motor Lofts waiting list is now open and accepting applications.

Ford City Motor Lofts offers affordable housing opportunities for applicants who meet the following eligibility criteria:

The Head of Household must be 55 years of age or older
All other household members must be 18 years of age or older

All applicants must meet HUD income eligibility requirements, not to exceed 60% of the Area Median Income (AMI) for Rowan County. Current income limits are listed below and are subject to change based on HUD guidelines.

The current limits are:

Household Size	Maximum Annual Income
1 person	$36,840
2 people	$42,120
3 people	$47,340
4 people	$52,620

All sources of household income must be disclosed, including wages, Social Security, pensions, disability benefits, unemployment, child support (whether received or court-ordered but not received), and any other recurring income. Verification is required for all sources, and all documentation must be dated within 90 days of submission.

Each adult applicant must submit a non-refundable $75.00 application fee. Only money orders or cashier’s checks made payable to Ford City Motor Lofts will be accepted.

Enclosed you will find the Application Packet, which includes:

Application Checklist – outlines the required documentation.
Application for Residency – to be completed and signed by all adult household members.
Additional Forms (if applicable) – such as the Affidavit of Zero Income, or Release of Information.

Please ensure your application is complete and that all required documents are attached. Incomplete applications will not be processed.

The Osceola Council on Aging complies with all federal and state Fair Housing and Equal Opportunity laws. Housing is offered without regard to race, color, religion, sex, disability, familial status, national origin, sexual orientation, or gender identity. Updated: 01/2026

Online Application Submission

This application is detailed and may take some time to complete. Please take your time and carefully answer each question to the best of your ability.

Be sure to complete all required fields before submitting the form. When you reach the bottom, click Submit to send your application. If anything is missing, the system will highlight those fields in red so you can easily find and correct them.

If a question does not apply to your situation, simply enter “None” or “0” in the required field. Everything in YELLOW below must be answererd. Leaving required fields blank WILL prevent your application from being submitted.

Thank you for your careful attention.

After submission, our staff will review your application and contact you once your eligibility and documentation have been verified.

We appreciate your interest in our affordable housing programs and look forward to assisting you through the application process.

Sincerely,

Angelica Rodriguez-Perez
Senior Vice President of Housing
Osceola Council on Aging

The Osceola Council on Aging complies with all federal and state Fair Housing and Equal Opportunity laws. Housing is offered without regard to race, color, religion, sex, disability, familial status, national origin, sexual orientation, or gender identity. Updated: 01/2026

Application Checklist for Ford City Motor Lofts

Eligibility Requirements

To qualify for Ford City Motor Lofts, the Head of Household must meet at least one of the following:

Age 55 or older

Applicants must also meet HUD income limits and other program requirements.

Required Documentation

Please submit the following items with your application. Incomplete applications may delay processing.

Completed Application for Residency
Non-refundable application fee: $75 per adult applicant (money order or cashier’s check only)
Valid photo identification for all adult household members (driver’s license or state ID)
Social Security cards for all household members
Proof of income for all household members (employment, Social Security, SSI, pension, etc.)
Most recent six (6) months of bank statements for all checking accounts
Most recent statements for savings accounts, certificates of deposit (CDs), IRAs, and other assets
Affidavit of Zero Income (if applicable)
Verification of asset sales or transfers (if applicable)

Additional documentation may be requested during the eligibility verification process in accordance with LIHTC and program requirements.

Pet Documentation (If Applicable)

Current rabies vaccination record for each pet
One-time pet fee: $300 per pet

Pets must be approved prior to move-in and must comply with property pet policies. Service and assistance animals are not considered pets and are subject to separate verification in accordance with Fair Housing regulations.

Staff Review Section

Eligibility Type: ________ Age 55+

Reviewed By: _____________________________

Date: _________________________

The Osceola Council on Aging complies with all federal and state Fair Housing and Equal Opportunity laws. Housing is offered without regard to race, color, religion, sex, disability, familial status, national origin, sexual orientation, or gender identity. Updated: 01/2026

Office Use Only:

Date Rec’d:

Time:am/pm

By (initials):

RENTAL APPLICATION

The following is to be completed
in its entirety by household members ages 18 and older.

Please answer ALL questions. Do not leave any blank spaces.
Write NONE or N/A where appropriate. Please print.

Development Name: Ford City Motor Lofts	Email: housing@osceola-coa.coms
Phone Number: (704) 310-8248	Address: 411 S Main Street, Salisbury, NC 28144

# of Bedrooms Desired:

Studio 1 Bedroom 2 Bedroom

PART 1 – HEAD OF HOUSEHOLD DATA:

Head of Household Name:	Phone #:
Mailing Address:
City/State/Zip:	Email:
Current Marital Status: Single Married Divorced Separated Widowed Have you ever used another name? Yes No If yes, please indicate name:

Directions to Member: Please complete the table below listing each member of the household.
Include all members who you anticipate will live with you at least 50% or more of the time during the next 12 months.

PART 2 – HOUSEHOLD COMPOSITION:

	FULL TIME STUDENT (Y/N)	INCOME (Y/N)
1.	Y N	Y N
2.	Y N	Y N
3.	Y N	Y N
4.	Y N	Y N

Anticipated changes in household size within the next 12 months?

Yes No

If Yes, explain:

Are there any absent household members who normally reside in the household?

Yes No

If Yes, explain:

Anticipated change in number of students within the next 12 months?

Yes No

If Yes, explain:

NCHFA – Updated 8/2025

PART 3 – HOUSEHOLD INFORMATION:

RENTAL HISTORY (must show most recent 2-year rental history)
Head of Household Member Name:
	Current Residence	Previous Residence	Previous Residence
Street Address:
City, State, Zip:
Select One:	Rent Own Other	Rent Own Other	Rent Own Other
If other, explain:
Owner/Landlord Name:
Owner/Landlord #
Reason for Leaving
Dates of Residency mm/yy	From: To:	From: To:	From: To:

RENTAL HISTORY (must show most recent 2-year rental history)
Spouse or Co-Head Of House Member Name:
	Current Residence	Previous Residence	Previous Residence
Street Address:
City, State, Zip:
Select One:	Rent Own Other	Rent Own Other	Rent Own Other
If other, explain:
Owner/Landlord Name:
Owner/Landlord #
Reason for Leaving
Dates of Residency mm/yy	From: To:	From: To:	From: To:

Have you or any member(s) of the household ever had your lease terminated or been evicted?

Yes No

Are you or any member(s) of your household receiving rental assistance (voucher, public housing, etc.)

Yes No

Are you or any member(s) of your household currently fleeing from an abusive situation?

Yes No

Are there any animals in the household?

Yes No

Would you or any member(s) of the household benefit from the features of an accessible unit?

Yes No

Do you or any member(s) require any accommodations and/or modifications to the unit for any disability?

Yes No

If yes to any question(s) above, please explain:

EMERGENCY CONTACT INFORMATION
Name:
Relationship: Phone #: Email:

NCHFA – Updated 8/2025

PART 4 – HOUSEHOLD ASSETS:

Do you or anyone in the household have any of the following assets? Please mark “yes” or “No” for each source of income.

	HEAD OF HOUSEHOLD		Co-HEAD		ADDITIONAL HOUSEHOLD MEMBERS
Type of Asset	Check One	Cash Value	Check One	Cash Value	Check One	Cash Value
Cash on Hand	Yes No	$	Yes No	$	Yes No	$
Depository Debit Cards	Yes No	$	Yes No	$	Yes No	$
Checking Accounts	Yes No	$	Yes No	$	Yes No	$
Savings/Money Market Accounts	Yes No	$	Yes No	$	Yes No	$
Certificates of Deposits	Yes No	$	Yes No	$	Yes No	$
Stocks/Bonds	Yes No	$	Yes No	$	Yes No	$
Trust Funds (excluding irrevocable)	Yes No	$	Yes No	$	Yes No	$
Real Estate/Land	Yes No	$	Yes No	$	Yes No	$
Mortgage or Deed of Trust	Yes No	$	Yes No	$	Yes No	$
Cryptocurrency (Bitcoin, etc.)	Yes No	$	Yes No	$	Yes No	$
Life Insurance (excluding Term)	Yes No	$	Yes No	$	Yes No	$
GoFundMe/Crowdsourcing	Yes No	$	Yes No	$	Yes No	$
Mobile Payment Services (Venmo, CashApp, etc.)	Yes No	$	Yes No	$	Yes No	$
Personal Property (Held as an investment)	Yes No	$	Yes No	$	Yes No	$
Other Investments	Yes No	$	Yes No	$	Yes No	$
Have you received any lump sum payments such as the following:
Inheritances	Yes No	$	Yes No	$	Yes No	$
Lottery or other Winnings	Yes No	$	Yes No	$	Yes No	$
Insurance Settlements	Yes No	$	Yes No	$	Yes No	$
Workers' Compensation Settlements	Yes No	$	Yes No	$	Yes No	$
Social Security Disability Settlements	Yes No	$	Yes No	$	Yes No	$
Unemployment Compensation Settlements	Yes No	$	Yes No	$	Yes No	$
VA Disability Settlements	Yes No	$	Yes No	$	Yes No	$
Severance Pay	Yes No	$	Yes No	$	Yes No	$
Capital Gains	Yes No	$	Yes No	$	Yes No	$
Other	Yes No	$	Yes No	$	Yes No	$

ASSET DETAILS (detail ALL assets for ALL household members marked yes above)

HOUSEHOLD MEMBER NAME	TYPE OF ASSET	BANK/FINANCIAL INSTITUTION NAME	# OF ACCOUNTS

I/We hereby certify that I/we HAVE HAVE NOT sold or given away assets for less than their fair market value within the last 2 years.
(Excluding items lost in bankruptcy, divorce, or foreclosure)

If Applicable: Identify all assets sold or disposed of for less than fair market value in the last two years.

HOUSEHOLD MEMBER NAME	ASSET DESCRIPTION	MARKET VALUE	DATE DISPOSED	AMOUNT RECEIVED

NCHFA – Updated 8/2025

PART 5 – SOURCES OF INCOME:

Is income received from any of the following sources? Please mark “yes” or “No” for each source of income.

	HEAD OF HOUSEHOLD		CO-HEAD		ADDITIONAL HOUSEHOLD MEMBERS
Type of Income	Check One	Monthly $	Check One	Monthly $	Check One	Monthly $
Employment	Yes No	$	Yes No	$	Yes No	$
Self-Employment	Yes No	$	Yes No	$	Yes No	$
Gig Income (Ride Share, Food Delivery, etc.)	Yes No	$	Yes No	$	Yes No	$
Regularly Recurring gifts	Yes No	$	Yes No	$	Yes No	$
Social Security	Yes No	$	Yes No	$	Yes No	$
SSI (Supplemental Security Income)	Yes No	$	Yes No	$	Yes No	$
Retirement Income	Yes No	$	Yes No	$	Yes No	$
Pensions	Yes No	$	Yes No	$	Yes No	$
Disability or Death Benefits (not SSI)	Yes No	$	Yes No	$	Yes No	$
TANF or other Public Assistance	Yes No	$	Yes No	$	Yes No	$
Alimony	Yes No	$	Yes No	$	Yes No	$
Child Support	Yes No	$	Yes No	$	Yes No	$
Unemployment Compensation	Yes No	$	Yes No	$	Yes No	$
Workers' Compensation	Yes No	$	Yes No	$	Yes No	$
Income from Rental Property	Yes No	$	Yes No	$	Yes No	$
Military Pay, including all allowances	Yes No	$	Yes No	$	Yes No	$
Severance Pay	Yes No	$	Yes No	$	Yes No	$
Annuities Income	Yes No	$	Yes No	$	Yes No	$
Insurance Policies Income	Yes No	$	Yes No	$	Yes No	$
Scholarships/Grants/Work Study	Yes No	$	Yes No	$	Yes No	$
Long Term Care Payments	Yes No	$	Yes No	$	Yes No	$
Income from Training Programs	Yes No	$	Yes No	$	Yes No	$
Other Income 1:	Yes No	$	Yes No	$	Yes No	$
Other Income 2:	Yes No	$	Yes No	$	Yes No	$
Other Income 3:	Yes No	$	Yes No	$	Yes No	$

INCOME DETAILS (detail ALL income for ALL household members marked yes above)

HOUSEHOLD MEMBER NAME	TYPE OF INCOME	COMPANY/PROVIDER NAME	CONTACT INFO

NCHaFA – Updated 8/2025

PART 6 – SIGNATURES:

Must be signed and dated by all members of the household age 18 & older:

I/we understand that the above information is being collected to determine eligibility for residence.

I/we certify that all assets currently held or previously disposed of and all income sources have been listed on this application. I/we further certify that the statements made in this application are true and complete to the best of my/our knowledge and belief and are aware that false statements are punishable under Federal law.

I/we authorize the owner/manager to verify information provided on this application and the signature(s) below are the consent to obtain such verification.

Printed Name	Confirm Full Name	Date

SUPPLEMENTAL DEMOGRAPHIC FORM

NCHFA – Updated 12/2022

The North Carolina Housing Finance Agency (NCHFA) requests the following information to comply with the
Housing and Economic Recovery Act (HERA) of 2008, which requires LIHTC properties to collect and submit
certain demographic and economic information to HUD. You may choose not to furnish this information and
will not be discriminated against based on your decision.

If you do NOT wish to furnish this information, please check the box below:

Applicant/Resident declines to provide demographic information

INITIALS	#	HOH	2	3	4	5	6	7
Applicant/Resident

APPLICANT / RESIDENT DEMOGRAPHIC PROFILE

HH #	Disabled (Y/N)	Veteran (Y/N)
1	Y N	Y N
2	Y N	Y N
3	Y N	Y N
4	Y N	Y N
5	Y N	Y N
6	Y N	Y N
7	Y N	Y N

Race Codes:
1 – White
2 – Black/African American
3 – American Indian/Alaska Native
4 – Asian (4a Asian Indian, 4b Chinese, 4c Filipino, 4d Japanese, 4e Korean, 4f Vietnamese, 4g Other Asian)
5 – Native Hawaiian/Other Pacific Islander (5a Native Hawaiian, 5b Guamanian/Chamorro, 5c Samoan, 5d Other)
6 – Other

Ethnicity Codes:
1 – Hispanic (1a Puerto Rican, 1b Cuban, 1c Mexican/Mexican American/Chicano, 1d Other Hispanic/Latino)
2 – Not Hispanic

Disability Status: “Y” if a household member meets the Fair Housing Act definition of disability.

Veteran Status: “Y” if the household member served in any branch of the U.S. Armed Forces, including National Guard or Coast Guard.

Form should be completed for all new move-ins.

NCHFA – Updated 12/2022

AUTHORIZATION FOR RELEASE OF INFORMATION

Property Name: Ford City Motor Lofts

Property Address: 411 S Main St Salisbury, NC 28144

I/We, the undersigned applicant(s), hereby authorize Osceola Council on Aging, Inc., its agents, property management staff, and service providers to obtain and verify any information necessary to determine eligibility for housing assistance and/or affordable housing programs.

This authorization applies to programs including, but not limited to:

- HUD-assisted housing programs, including Section 202 PRAC

- Low-Income Housing Tax Credit (LIHTC) programs under Internal Revenue Code Section 42

- Any federal, state, or local housing program for which the household applies

Information Authorized for Release

- Employment, wages, and unemployment benefits

- Social Security, SSI, SSDI, pensions, and other benefits

- Bank accounts, assets, and asset income

- Public assistance or other income sources

- Rental history and housing assistance history

Entities Authorized to Release Information

- Employers and former employers

- Financial institutions

- Social Security Administration

- Benefit providers and government agencies

- Housing authorities and prior landlords

Use and Disclosure of Information

The information obtained will be used solely for the purpose of determining eligibility, ongoing compliance, and program monitoring. Information may be shared, as required, with:

- U.S. Department of Housing and Urban Development (HUD)

- North Carolina Housing Finance Agency (NCHFA)

- Investors, syndicators, and compliance monitors

- Auditors and regulatory agencies with jurisdiction

Duration of Authorization

This authorization is valid for fifteen (15) months from the date of signature and may be used for initial eligibility determination and recertifications during that period, unless revoked in writing.

Revocation

I/We understand that this authorization may be revoked in writing at any time, except to the extent that action has already been taken based on this authorization. No Impact on Eligibility I/We understand that refusal to sign this authorization may result in delays or denial of housing assistance due to the inability to verify required information.

Spouse Co-Head Other Adult None
Name:	Phone #:
Mailing Address:
City/State/Zip:	Email:
Current Marital Status: Single Married Divorced Separated Widowed Have you ever used another name? Yes No If yes, please indicate name: