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Pre-Application - Waitlist

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Preliminary Application

For 3 Bedroom Waitlist Only

122 Wilton Road Apartments offers 19 affordable units for lease. Twelve of these apartments will receive rental assistance from the Department of Housing, with rents set at 30% of adjusted income. The remaining six units will be rented at 60% and 80% of the State AMI.

Waitlist is CLOSED.

First name*

Last name*

Email*

Phone*

Address*

Zip Code*

Total Number of Adults, 18 and over:*

Total Number of Children under 18:*

Bedroom Size Request:*

3-bedroom

Wheelchair accessible unit needed:*

Yes

Are you Elderly?

Yes

Do you own any pets?*

Yes - Not Certified

Yes - Certified SA/ESA

Pets are not permitted unless the animal is a certified Service Animal or Emotional Support Animal with appropriate documentation for verification.

Total estimated yearly income for everyone in your household before taxes, when combined:*

Will this be your only place of residence?*

Yes

Will you take an apartment when one is available?*

Yes

Do you currently receive any rental assistance - (RAP or Section 8) ?*

Yes

If Yes, Please Explain:

Student Status*

Full-Time

Part-Time

Not a student

Please check off if you or a family member in your household have any of the following assets listed below:*

Checking or Direct Deposit Accounts

Savings Accounts

Certificate of Deposit

IRA

Other Retirement Funds

Mutual Funds

Stocks or Bonds

Life Insurance

Trust Accounts

Real Estate

Please comment on the question above or provide any additional information about your application and interest in WRCH 122 Wilton Road Apartments:

Signature*

Signature field is empty.

ADDRESS

122 Wilton Road

Wesport, CT 06880

CONTACT

leasing@millennium-realty.com

Tel: 860-855-7606

WRCH 122 Wilton Road

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Financed by DOH

Equal Housing Opportunity

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