CITY OF SCOTTS VALLEY
Affordable Housing Program
Eligibility Determined by the
Housing Authority of the County of Santa Cruz
Tel: 831 454-9455 Fax: 831 469-3712
Application to Purchase/Rent Checklist
You must submit the following items to the Housing Authority to process your application:
1. Eligibility Application (attached)
Complete, date, and sign.
2. Processing Fee
A check for $135.00 as of January 2, 2013 (or current amount by calling Planning Dept.
Staff) made payable to the Housing Authority of the County of Santa Cruz, must be
submitted with your application. If you are a renting a unit, this fee must be paid by and
submitted by the property manager or owner.
3. Authorization to Release (attached)
This form must be completed to allow Housing Authority staff to communicate with
various individuals regarding your eligibility.
4. Verification of Residency
Purchasers: To meet the criteria “Lives in Scotts Valley”, documentation must be
submitted to verify that your current residence is located within the City of Scotts Valley
(within the City’s boundaries). Utility or other service statements/invoices dated 6-
months prior to application submittal and a current statement/invoice that still shows the
same address are generally acceptable. After submitted, sufficiency of the
documentation will be made. You will be notified if additional or other documentation is
Renters: If this is an initial application, you must submit the same evidence as required
by purchasers. All other renters may ignore this.
5. Gross Income (see attached Verification of Employment form)
Third party verification of the gross income of each adult family member in your
household must be provided. If employed, the employer of each adult member of the
household must complete and submit to the Housing Authority a Verification of
Employment. This verification may be sent via fax to (831) 469-3712. In addition,
please submit a copy of your most recent pay stub.
6. Self Employment
If self-employed, third party verification of your income must be provided. A limited
review of the financials by a Certified Public Accountant is generally the most acceptable
form of verification. You may choose to submit some other form of third party
verification. A determination will be made regarding the sufficiency of the information. If
additional information is needed you will be notified. In addition, please provide a
complete, signed copy of your most recent Federal Income Tax return. This will require
a ‘wet’, or new, signature. All appropriate schedules, W-2s, and 1099s must be
7. All other Income (see attached Verification of Deposit form)
You must provide third party verification of all other earned or unearned income
(interest, dividends, bonuses, retirement benefits, rental income, disability payments,
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social security payments, unemployment, etc.) and all sources of funds. A copy of the
most recent Award or Benefit Notification letter, earnings statement, account statement,
lease agreement, etc., may be sufficient. If after review, additional documentation is
required you will be notified.
8. Savings and or Checking Accounts
You must provide third party verification of all amounts held in all checking and or
savings accounts. Please provide copies of your most recent statement(s) and have
your bank complete and return to the Housing Authority a completed Verification of
Deposit for each checking and/or savings account held in the household. The
verification may be sent via fax to 831-469-3712. In addition, please submit a copy of
your most recent bank statements for each account you hold.
9. Alimony or Child Support
If you receive Alimony and or Child Support, you must provide us with a copy of your
most recent Alimony or Child Support court decree indicating current payment schedule.
If separated, submit legal separation documents showing the payment schedule and
10. Stocks and Bonds
If you own stocks or bonds (including savings bonds) a Statement of Value from a
Broker, bank, or CPA must be provided.
11. Real Estate
If you own property (either a share or entirely), a Statement of Estimated Market Value
prepared by a Real Estate Broker on letterhead, Bank Statements or a report from the
County Assessor’s Office must be provided to establish third party verification of the
12. Federal Income Tax
Please submit a copy of your most recently filed Federal Tax return. This must include
a ‘wet’, or new, signature. Include all appropriate Schedules, W-2s, and 1099s. If any
adult in the household was not required to file a tax return in the most recent filing year,
they must complete and submit the attached ‘Income Tax Affidavit’.
For Purchasers Only: You must submit the last three years of your filed Federal Tax
returns. They must include a ‘wet’, or new, signature. Include all appropriate
Schedules, W2s, and 1099s. If any adult in the household was not required to file a tax
return in any of the last three years, they must complete and submit the attached
‘Income Tax Affidavit’.
13. For Purchasers Only (see attached Lender & Title Company Information form)
Complete and submit the Lender and Title Company Information form. This will allow us
to coordinate the exchange of documentation to facilitate a timely closing.
14. For Renters Only
Must submit a copy of Lease.
All requested information must be verified by documents reflecting the most current data.
Please review this list to make sure that you include all the information that applies to you.
The most thorough and complete applications receive priority processing.
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