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Housing

EMR Online Application

Eagle Manor Residences

715 N. FEE STREET HELENA, MT 59601 (406) 442‐0610 TTY 711 EMAIL: gdensmore@rmdc.net
All utilities are paid except Telephone, Internet, & Cable.
PEM & EM2 include a Mandatory Meal Program. If you do not want to participate in this program, Eagle Manor III
does not have this requirement. The current monthly rate per person is $175.00 and includes 1 meal per day.

YOUR APPLICATION WILL NOT BE ACCEPTED UNLESS THE FOLLOWING ITEMS ARE ATTACHED TO YOUR APPLICATION.
WE CAN PHOTOCOPY ITEMS FOR YOU IF NEEDED:
1. CURRENT SOCIAL SECURITY BENEFITS STATEMENT
2. DRIVER’S LICENSE OR PHOTO ID
3. SOCIAL SECURITY CARD
4. BIRTH CERTIFICATE

RENTAL SCREENING CRITERIA
Incomplete applications or applications with incorrect information will be denied.
 Applicant must have form of income to apply.
 Occupancy must be limited to no more than 2 persons per bedroom
 The prospective resident must initially provide unmistakable identification. A driver’s license or other Picture ID
is acceptable. Valid proof of a social security number is also required.
 Our apartment complex provides homes for senior citizens at least 62 years old and for persons with disabilities.
You must meet one of these criteria to qualify for residency. Our Tenant Selection Plan allows us to give
preference to the elderly.
 No less than five (5) years of current and previous verifiable landlord references are to be listed on the
application provided with telephone numbers and addresses. If no rental history, then you must provide 3
professional references. If you own your own house or mobile home when you apply, landlord references are
not necessary.

Inability to meet any of the above criteria for residency will result in the denial of the application for residency.
Please note: we will run criminal & credit background checks before offering an apartment.
Rocky Mountain Development Council, Inc. does not discriminate on the basis of Race, Color, National Origin, Religion, Sex, Familial Status, Physical or
Mental Disability, Creed, Marital Status, Political Beliefs, Veterans’ Status, Age, or Sexual Orientation, Gender Identity or Expression, or Genetic
Information
Revised: 9/27/23

No file selected
In order for us to place you on the correct Waiting List(s) and thereby provide you with the type of unit and rent structure you require, please complete the following survey. Note: Check all answers that apply (you can select more than one answer to each question.)
First Name *
Last Name *
Please note that current residents who requested a one‐bedroom when they moved into an efficiency apartment are given preference for a one‐bedroom apartment before it is offered to Waiting List Applicants. Therefore, if you would prefer a one‐bedroom, we encourage you to accept an efficiency unit when available and asked to be placed on our one‐bedroom transfer list.
Do you require any special features in your apartment?
Do you currently have a Housing Choice, Section 8, or similar voucher for housing assistance?
If no, do you require Section 8 assistance (help with your rent payment) in order to move in?
If you answered yes, please contact Helena Housing Authority at (406) 442‐7970 to apply for a voucher. They are located at 812 Abbey Street, Helena, Mt 59601. You can also go to their website: www.hhamt.org for more information. If you are a veteran, the VA has a VASH Voucher Program that we encourage you to look at. **PLEASE REMEMBER THAT WE HAVE LIMITED PROJECT BASED SECTION 8 ASSISTED APARTMENTS**

If you change your mind about which Waiting List you wish to be on, we will add you to other lists as of the date you
make the change known to us.
Thank you for your assistance in completing this form. If you have questions about this information, please contact us at
(406) 442‐0610 or TTY711.

First Name
Last Name
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Applicant Citizen
Applicant Student
First Name
Last Name

Other household members:

First Name
Last Name
Month
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Year
Household Member 1 Citizen
Household Member 1 Student
First Name
Last Name
Month
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Household Member 2 Citizen
Household Member 2 Student
Optional (used for reporting only)
Optional (used for reporting purposes only)

NOTICE: You are required to notify the Property Manager of ANY change of address and/or phone number. If we cannot contact you at the phone number you provide us, your name will be removed from the waiting list and you will need to re‐apply.

Country
Address Line 1
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State/Province
Postal Code

How long at current address?

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First Name
Last Name

Current Landlord

**FIVE YEARS’ WORTH OF LANDLORD REFERENCES ARE REQUIRED UNLESS YOU OWN A HOME OR MOBILE HOME**

Country
Address Line 1
City
State/Province
Postal Code
Month
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Country
Address Line 1
City
State/Province
Postal Code
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Please list any other previous addresses in the last 5 years in the text box below.

Required Income and Asset Information

Income Sources

Please list ALL 1) income sources followed by their 2) gross monthly and 3) net monthly amounts. Examples of income sources include wages, social security, pensions, etc.

Assets/Bank Accounts

Please list ALL assets or bank accounts by 1) the bank of financial institution, followed by 2) the account type, and  3) approximate balance. Examples of accounts include checking, savings, CD's, IRA, Annuities, etc.

Do you own a mobile home?
Is there a mortgage on the home (reverse mortgage does not apply)?

You must answer ALL of the questions below truthfully with full disclosure. Failure to do so will result in denial of your application. If you accepted and we find there has not been full disclosure, it could lead to eviction.

Have you/anyone who will be sharing the apartment with you ever been charged with criminal offenses or DUIs?
Do you/anyone in your household who will be sharing the apartment with you have a felony conviction?
Are you required to register as a lifetime sex offender in this or any other state?
Have you had credit under any other name?
In the last two (2) years, have you/any household member who will be sharing the apartment with you disposed of assets for less than fair market value?
Have you/anyone in your household who will be sharing the apartment with you ever been convicted for the use, sale, manufacture, or distribution of controlled substances?
Do you/anyone in your household who will be sharing the apartment with you currently use illegal drugs?
Have you/anyone in your household who will be sharing the apartment with you ever been evicted?
Have you/anyone in your household who will be sharing the apartment with you been evicted from federally assisted housing in the last five years?
Are you currently receiving tenant‐based or project based assistance from HUD/USDA/or similar?
Will this apartment be your only residence?
Do you own any pets?

This property does not recognize any preferences except income requirements per HB‐1‐3560 Appendix 1 Section 3560.257. 
In compliance with the Fair Credit Reporting Act, we are informing you that information as to your character, general reputation, and mode of living will be verified.

You have the right to dispute the information reported.  The facts set forth in this application are true and complete.  I/We understand that any misrepresentation of information or failure to disclose information requested on this application may disqualify me from consideration for admission or participation and may be grounds for eviction or termination of assistance.  You agree to all the above and sign this of your own free will. 

I/We further understand that, upon acceptance of this application for a tenancy, I/WE must provide verification of all income, all assets, and household composition, and sign a Lease Agreement, Property Rules and Regulations, and a Tenant Income Certification. 

You, as the prospective tenant(s), agree that a complete investigation of all information on this application will not constitute an invasion of privacy.  I/We are aware of and extend the privilege to its representatives to obtain credit reports, current & previous landlord references, and/or character reports as necessary. 

WARNING: Title 18, Section 1001 of the U.S. Code, states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any Department or Agency of the U.S. or the Department of Agriculture.

Before submitting your application, please review your notice of occupancy rights under the Violence Against Women Act using the file link below.

Rocky Mountain Development Council, Inc. does not discriminate on the basis of Race, Color, National Origin, Religion, Sex, Familial Status, Physical or Mental Disability, Creed, Marital Status, Political Beliefs, Veterans’ Status, Age, or Sexual Orientation, Gender Identity or Expression, or Genetic Information

APPLICATION REVISION DATE: 7/1/2020

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