Before you begin

Please answer every question. If something does not apply to you, write “N/A.” Every adult (18 or older) who will live in the home must sign. You can also apply on paper. If you need help, or need this application in another format, please call us; we are glad to help. If there is a waitlist, your priority is set by the date and time we receive a COMPLETE application. If anything is missing, we will contact you within 10 days to let you know. We accept all lawful sources of income, including housing vouchers and rental assistance.

Every household is expected to be able to meet the basic responsibilities of tenancy — to pay rent on time, to keep the home clean and in good condition, and to not disturb your neighbors. You do not have to be able to do these things without help. If anyone in your household has a disability and needs a reasonable accommodation, you may ask for one at any time.

Family Summary

Start with the head of household, then add everyone else who will live in the home.

Full nameRelationship to head of householdDate of birthSocial Security numberNever issued a Social Security numberFull-time student (age 18 or older)
Do you expect your household size to change in the next 12 months (for example, a new baby or a family member moving in)?

Please do not tell us about a pregnancy specifically, only whether you expect a change in household size.

Is every member a U.S. citizen or an eligible noncitizen? (optional)

Some federal rental assistance is limited to U.S. citizens and noncitizens with eligible immigration status. USDA has not yet put this rule into effect for our communities. If it does, we will ask each household member to sign a status declaration. Your answer here will not by itself stop us from processing your application.

How to reach you

We use this to send you a dated confirmation when we receive your application, and to keep you updated. No email address? Please apply on paper.

How should we send you written notices about your application?

Every notice about your application (anything missing, your place on the waiting list, or our decision) comes to you in writing. We may call you to set up an appointment.

The home you are applying for

You are applying to Leonard's Freehold, 41485 Connelly Street #35, Leonardtown, MD 20650.

How many bedrooms do you need?
Does anyone in your household need an accessible or adapted home?

Asking for an accommodation, including an assistance animal, is free and will never count against your application. You may ask at any time, now or after you move in. You do not have to share a diagnosis.

Household income

Add every source of income for everyone who will live in the home, before taxes. Include earned income (wages, self-employment, side-gigs) and unearned income (Social Security, SSI, pensions, benefits, support, and so on).

Who receives itType of incomeGross amountHow often

Household assets

List every asset for everyone in the household. Assets include things like bank accounts, cash, stocks, jewelry, and real estate. Exclusions: retirement accounts (401ks), educational savings accounts (529s), and everyday personal belongings (family car). Please be thorough, we are required to verify every household's assets.

Type of assetCurrent valueAmount still owed (real estate)
In the last 2 years, has anyone in the household sold or given away anything of value for less than it was worth?

Any amount counts — there is no minimum. Do NOT count anything lost through foreclosure or bankruptcy. Property divided in a divorce or separation settlement usually does not count either, because the law treats it as exchanged for fair value.

Deductions

These may qualify your household for deductions. Answer the questions below — we only ask for dollar amounts where they apply to you. Every amount should be what you actually pay OUT OF POCKET (what is not reimbursed or paid by insurance, a program, or anyone else).

Do you pay for childcare for a child under 13 so that an adult can work, look for work, or go to school?
Does a household member with a disability have out-of-pocket costs (care or equipment) that let a family member work?
Is the head of household, spouse, or co-head 62 or older, or a person with a disability?

Only elderly or disabled households can deduct medical expenses.

Housing History

List each Adult's current home first, then previous homes and landlords for each Adult household member.

Current home
Which household members lived here?

Check everyone from your household who lived at this address.

In the last 5 years, has a court ordered anyone in your household to leave a rental home (an eviction judgment)?

Do not include cases that were dismissed, that you won, or that a court has shielded, sealed, or expunged.

In the last 5 years, has anyone in your household received a written notice of lease violations from a landlord?

References

Please give two references for the adults in your household — for example a current or former employer, a teacher, or someone who knows you well. Please do not list relatives.

NamePhoneHow they know you

Federal rules require us to check the sex-offender registry in each state where household members have lived. Leave blank if you have lived only in your current state.

Required questions

Read each statement and check ONLY the ones that are true for your household. If none are true, leave them all unchecked.

You do not have to tell us about any arrest, charge, or conviction that has been sealed or expunged by a court or by law. Leave those records out when you answer the questions below. We will not deny your application because you left out a sealed or expunged record.

Check all that apply to your household: (optional)
Do you currently receive other rental assistance or a Housing Choice Voucher?
Do you currently live in subsidized housing?

These are the only criminal-history and subsidy questions on this application. We do not ask about arrests or charges, and we do not require drug or alcohol tests. If you are selected, we will make you a conditional offer before we run a criminal background check. After a conditional offer we may consider only felony convictions from the 5 years before you applied, in Maryland, another state, or federal court, and any conviction listed above that was not disclosed. You may give us written evidence that a record is wrong, evidence of rehabilitation, or other mitigating information, and we will do an individualized assessment. If we withdraw an offer, we will tell you the specific reason in writing. You may then ask us to reassess by giving us written evidence, and within 30 days you may ask for a copy of everything we relied on.

Additional questions

Pet policy summary: Pets 25 lbs or under are welcome with the office's written permission before the pet moves in, up to one dog and two cats per home. There are no breed restrictions beyond the weight limit. There is no pet fee, pet deposit, or monthly pet charge. Each pet must be current on its rabies shots and licensed as local law requires. Assistance animals are not pets.

Do you have any pets? (optional)

An assistance animal for a disability is never counted as a pet. The pet policy summary is printed above.

Your certification and signature

If we deny your application, or take other adverse action, based on a consumer or tenant-screening report, we will tell you in writing, name the company that supplied the report, and explain your right to a free copy of it and to dispute it.

Applicant signature

Every adult (18 or older) who will live in the home must sign. On paper, sign and date here; online, checking the boxes above and submitting serves as your electronic signature, and you may request a wet-signature form instead.

Voluntary reporting

The information regarding race, ethnicity, and sex designation solicited on this application is requested in order to assure the Federal Government, acting through the Rural Housing Service, that the Federal laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age, and disability are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race, ethnicity, and sex of individual applicants on the basis of visual observation or surname.

Ethnicity (optional)
Race (choose all that apply) (optional)
Sex (optional)

Your rights under the Violence Against Women Act (VAWA)

Federal law protects applicants and tenants who are victims of domestic violence, dating violence, sexual assault, or stalking. You cannot be denied housing, or have your tenancy ended, because you are or have been a victim of these crimes. You have the right to confidentiality and to certain protections and emergency transfers.

You will receive the full VAWA Notice of Occupancy Rights (form HUD-5380) and the certification form (HUD-5382) when you are admitted, or with any notice that your application is denied, and you may ask us for them at any time.

USDA nondiscrimination statement

The current USDA nondiscrimination statement applies to this community. The full statement is included with your application packet and on our website.

Read the full USDA nondiscrimination statement.

Notice to Applicants: Fair Chance Housing Act Criminal History Screening Process

This is the model notice published by the Maryland Department of Housing and Community Development. Please read it; Section 9 asks you to confirm you received it.

In accordance with the Maryland Fair Chance Housing Act, this notice is provided to explain how your criminal history record will be screened as part of your housing application. This process ensures that your application will be reviewed fully and fairly. This notice must be provided before you pay an application fee. Read the process below to understand how your eligibility will be determined:

1) Prequalification

This step includes the landlord’s routine tenant screening, including checking your credit history, employment, income, payment delinquencies, bankruptcies, etc. This step does not screen for conviction history.

However, the landlord can ask you to disclose whether you have any of the following convictions under the Maryland Criminal Law Article, which may be grounds for a denial:

• Child Pornography Crimes under §11-207

• First or Second-Degree Murder under §2-201 or §2-204

• Human Trafficking under §3-1102

• Sex offenses under Title 3, Subtitle 3

• Out-of-state or federal equivalents of any of the above

You can also be asked to disclose:

• Whether you are currently required or have ever been required to register on a sex offender registry in Maryland or any other state.

If you are applying to live in federally assisted housing, you can also be asked to disclose if you have a conviction for:

• Producing, manufacturing, distributing, or dispensing methamphetamine in federally assisted housing.

2) Conditional Offer and Criminal Background Check

If you pass the prequalification stage, you will be given a “Conditional Offer” of housing. A conditional offer is not a final offer for housing. It is contingent upon the limited criminal history background check permitted under the Fair Chance Housing Act.

The following convictions can be the basis for a denial of a conditional offer:

• A felony conviction within the past five years,

• Convictions from the prequalification stage that were not disclosed, and

• Any out-of-state equivalents

3) Approval OR Denial and Right to Request a Reassessment

Your application may be approved, or the conditional offer may be withdrawn. If the conditional offer is withdrawn, the following needs to happen:

• The landlord will provide you with a written notice that includes the specific reason(s) why the conditional offer was withdrawn.

• Within 30 days of receiving the written notice, you can request that the landlord provide a copy of all of the information they used when considering your application, including criminal history records.

• Landlords must provide a response within 10 days of receiving the request.

If your application is denied, you have the right to request an individualized assessment. You must request an individualized reassessment in writing.

4) Reassessment

The Maryland Department of Housing and Community Development’s Office of Tenant and Landlord Affairs (OTLA) has created a worksheet that you can use to guide your individualized assessment request.

The housing provider is not required to use the OTLA worksheet and can ask you to use a form they provided. However, the OTLA worksheet can help guide you in deciding what information to provide in your individualized assessment request.

If you do not use the OTLA worksheet, your individualized assessment request must be signed under penalty of perjury.

Prefer to apply on paper? Get the paper application on our Apply page, or call (301) 475-9005 during Monday–Friday, 10:00 AM–3:00 PM, closed for lunch 12:00–1:00 PM (Eastern Time) and we will help you.