Fill in a Valid Rochdale village application Form

ROCHDALE VILLAGE INC.

Dear Applicant,

We welcome your interest in becoming a cooperator at Rochdale Village, Inc.

Rochdale Village, Inc. is situated on 120 acres that was once home to the Jamaica Race Track. The village is composed of a total of twenty (20) buildings, divided into five groups. Each group contains four buildings and each building has three sections with their own mailing address.

On site are shopping centers, nursery and public schools, basketball and tennis facilities, a community center and senior center services. Rochdale Village is patrolled by its own security force.

Rochdale Village is convenient to public transportation, including the Long Island Railroad, local and express buses to Manhattan; minutes away from major highways and close to Nassau County, major beaches and recreation areas.

HOW TO SUBMIT YOUR APPLICATION:

When returning this pre-application, include a $25.00 non-refundable money order processing fee payable to Rochdale Village, Inc. Mail to:

Rochdale Village, Inc.

P.O. Box 218

Jamaica, N.Y. 11434.

PROCESSING FEES MUST BE PAID BY MONEY ORDER ONLY

Only original pre-applications will be accepted (no duplications).

Rochdale Village, Inc. will reject applicants whose tenancy or credit record is inconsistent, or who have a recent history of serious deficiencies in overall credit or in rent payment or general tenancy, including, but not limited to, any credit flaws such as bankruptcy, eviction proceedings, lateness in credit payment, late in rent or mortgage payments, and the need for third party co- signers. Credit rating must be 680 or above.

Rochdale Village, Inc. reserves the right to reject applicants based on negative Home Visit reports and/or Criminal Background reports.

ROCHDALE VILLAGE INC.

VETERANS PREFERENCE

Summary of Civil Service Law

Section 85 Definition of Veteran

Eligibility

Veterans eligible for the veterans’ preference are those who:

a.Were members of the Armed Forces of the United States;

b.Served on active duty for other than training purposes in time of war1;

c.Were discharged honorably or released under honorable circumstances;

d.Are residents of New York State; and

e.Have documented their eligibility by submitting Form DD214 (NAVPERS-553 / NAVMC-78 PD / WDAG-53, 98 and for service in Lebanon, Grenada, or Panama, the award of an appropriate expeditionary medal.

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1Time of war includes the following wars and hostilities:

(*Service during these periods is qualifying only if veteran received the armed forces, navy or marine corps expeditionary medal.)

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ROCHDALE VILLAGE INC.

Date____________________

How did you hear of Rochdale Village?____________________________________________________________

Apartment Size You Are Requesting

(The apartment size must be indicated – you may only request one size)

Jr.1BR 1BR 1BR w/Terrace

2 BR  2 BR w/Terrace  3 BR  3 BR w/Terrace

Name:

Address:

City/State/Zip:

Length of Occupancy:____________Years ___________Months

Monthly Rent/Mortgage: $________________________________

Previous Address (if less than 2 years at current address):

_____________________________________________________________

**If you indicated you are a veteran or the surviving spouse of a veteran, please attach a copy of Form DD214 (NAVPERS-553 / NAVMC-78 PD / WDAG-53, 98 and for service in Lebanon, Grenada, or Panama, the award of an appropriate expeditionary medal.

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ROCHDALE VILLAGE INC.

Employment and Income Information

List the following for each Earner:

Employer: ____________________________________________________________

Position: _______________________ Annual Income: ____________________

Length of Employment: ___________ Earnings (W2) for last Year: __________

Employer: ____________________________________________________________

Position: _______________________ Annual Income: ____________________

Length of Employment: ___________ Earnings (W2) for last Year: __________

Employer: _____________________________________________________________

Position: _______________________ Annual Income: _____________________

Length of Employment: ___________ Earnings (W2) for last Year: ___________

Employer: ______________________________________________________________

Position: _______________________ Annual Income: ______________________

Length of Employment: ___________ Earnings (W2) for last Year: ____________

Please list any other income and source:

________________________________________________________________________

________________________________________________________________________

Present Total “Other” Income $____________

Present Total “Family” Income $____________

SUBTOTAL $____________

Source of Equity Payment

From what source(s) will you get the money to pay the equity for this apartment?

________________________________________________________

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ROCHDALE VILLAGE INC.

Please Read and Sign Below

(A)SPECIFICALLY UNDERSTAND THAT THE FILING OF THIS PRE- APPLICATION DOES NOT IN ANY WAY BIND ROCHDALE VILLAGE INC. TO RESERVE OR ASSIGN AN APARTMENT TO ME.

(B)ANY SOLICITATION OR ACCEPTANCE OF GRATUITY TO OBTAIN AN APARTMENT IS ABSOLUTELY PROHIBITED BY ROCHDALE

VILLAGE INC. AND IS ILLEGAL.

(C)I understand that in order to be accepted as an approved applicant, I am required to attend one (1) mandatory orientation session. All applicants are subject to a full credit investigation, including a home visit at the time of offering of apartment.

(D)All applicants accepting apartments will be responsible for supplying their own stove and refrigerator (electric stoves are not allowed).

(E)Rochdale Village, Inc. does not permit dogs, cats, washing machines, clothes dryers, air conditioners or freezers.

(F)I certify that the statements made in this pre-application are true and complete. I have no objections to inquiries for the purpose of verifying the facts stated.

APPLICANTS’ SIGNATURE

x__________________________________

x__________________________________

x__________________________________

x__________________________________

x__________________________________

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