Multifamily Affordability Verification Application

Please complete this form and upload relevant documentation in the “Supporting Documentation” section.

Affordable housing is defined as projects in which at least 25% of the units are, or are expected to be, occupied by households earning not more than 80% of the Area or State median income, whichever is higher. Multifamily buildings are buildings with 5 or more dwelling units.

There are two options to meet this requirement:

Option 1: Proxy Documentation (upload in the “Supporting Documentation” Section):  NYSERDA allows certain proxies to represent compliance with the above definition. The Affordability Eligible Proxies table lists eligible proxies and supporting documentation.

Option 2: Rent Roll (upload in the Supporting Documents Section): 

*Applicants are required to utilize the NYSERDA approved Rent Roll tool when applying to the Multifamily Affordability Program.

If you are working with a Contractor and would like them to be kept apprised of the status of this application please complete this section below.

A project may include multiple buildings. Please identify the total number of buildings associated with the project, provide a single address in the form below, and upload a file of addresses for each building included in the project.

If you have more than one building in your project, upload a Word or Excel file for the additional building addresses. The file must include street address, city, state, and zip code for each building.

Please ensure your document file name does not include any special characters, such as ~! @#$%^&*_-+=`|\(){}[]:;"'<>,.?/.

By signing below, I certify that all information provided on this application, including statements and documents submitted in connection with this application, are correct and complete to the best of my knowledge. I acknowledge that NYSERDA has retained a Contractor to process my affordable multifamily housing qualification application. If necessary, I further agree to provide additional information to complete my affordable housing screening application process.

I further acknowledge and agree that NYSERDA and its Contractor may share with and disclose to, orally and/or in writing the project partners identified by me above, or as subsequently identified by me to the Contractor, the following information regarding this application; whether the application has been approved by the Contractor, and any additional items requested by the Contractor in order to complete my affordable housing qualification application; whether the application has been approved by the Contractor; and whether my application has been denied, so that the project partner(s) can determine whether I intend to proceed.

I understand that my signature on this form gives permission for NYSERDA, or its designee, to verify records necessary to assure my program eligibility. I understand that if I give false information or withhold information in order to make myself eligible for benefits that I am not entitled to, I can be prosecuted to the fullest extent of the law.

I understand this application does not guarantee assistance will be granted but will be used in determining eligibility for the program. Whether or not an eligible applicant will be provided assistance will depend in part upon the number of applicants received, the remaining funding available, and the priorities to be met by the program.

Whether or not the undersigned have elected to sign this document electronically, the Contractor, and or any subsequent holders of this document, shall have the right to convert and store the manual signature electronically, and the undersigned consents to the use of electronically stored version in the same manner as an original signed copy.

I understand and intent that a legal signature is formed by entering my name on this and other documents provided to me, and by entering my name on this and other documents provided in relation to this transaction I intent for my electronic signature to have the same force and effect as my manual signature. If any of the parties do not wish to sign this document electronically, all must opt out together and request a paper copy to sign manually.