Senior Housing 55+ % Special Needs* % Projects for Individuals incomes at or % below 45% AMI Projects for Individuals with % Children/Families with Children at or below 45% AM Income / Mixed Use % Veterans Housing % *Special Needs Population(s) Targeted Preference Points for Above Projects see QAP Sections 14.13 – **Number and percentage Two of: One bedroom / %, bedroom / %, Four Three / %, bedroom / %, Other* / % bedroom Commercial Space- Does the project contain any commercial / retail space? Yes No Census Tract Number QCT? Yes No DDA? Yes No State Senate State Assembly Congressional City District District District District N/A Metropolitan Statistical Area Number is the project part of an organized plan? Yes No Does the Applicant/Co-Applicants have ownership of the land? Yes No Total Cost of Land Size of the Site (Acres or Square Footage) Date of Purchase Insurance Company Officer Telephone Fax Number Number Name of vested owner on Preliminary Title Report Name of Seller Address
Senior Housing 55+ % Special Needs* % Projects for Individuals incomes at or below 45% AMI % Projects for Individuals with Children/Families with Children at or below 45% AM % Income / Mixed Use % Veterans Housing % *Special Needs Population(s) Targeted Preference Points for Above Projects – see QAP Sections 14.13 **Number and percentage of: One bedroom / %, Two bedroom / %, Three bedroom / %, Four bedroom / %, Other* / % Commercial Space- Does the project contain any commercial / retail space? Yes No Census Tract Number QCT? Yes No DDA? Yes No State Senate District State Assembly District Congressional District City District N/A Metropolitan Statistical Area Number is the project part of an organized plan? Yes No Does the Applicant/Co-Applicants have ownership of the land? Yes No Total Cost of Land Size of the Site (Acres or Square Footage) Date of Purchase Insurance Company Officer Telephone Number Fax Number Name of vested owner on Preliminary Title Report Name of Seller Address