PCGA Housing Application

Step 1

Let’s confirm basic eligibility.

Palm City Garden Apartments serves households whose head, spouse, or sole member is age 62 or older, or a person with a disability. Final eligibility is determined by management.

Does anyone in the household meet either qualification? Required Age 62 or older Person with a disability

Will this apartment be the household’s only residence? Required Yes No

Preferred apartment type Required Efficiency One bedroom Either

Step 2

Tell us about the primary applicant.

First name Required

Last name Required

Other names previously used

Date of birth Required

Last four digits of SSN RequiredDo not enter the full Social Security number.

Current street address Required

City Required

State Required

ZIP Required

Primary phone Required

Email addressEmail is optional, but required to check your status online. Without email, please call the office for updates.

How did you learn about Palm City Garden Apartments?

Are you a former PCGA tenant? Yes No

Step 3

Who will live in the apartment?

Include the primary applicant and every other household member. Full Social Security numbers are not collected in this initial application.

Emergency contacts

Provide two relatives or close friends who generally know how to reach you.

Step 4

Income and current housing.

List monthly income from Social Security, SSI, VA benefits, employment, or other sources. Staff may request verification later.

Is the household currently living in subsidized housing? Required Yes No

Present landlord

Landlord name

Landlord phone

Landlord address

Have you ever been evicted? Yes No

Step 5

Support and accommodation.

Do you need help completing this application? Yes No

Would you like to request a reasonable accommodation or communication assistance?Do not include medical records or a diagnosis. Staff will contact you about next steps.

Verification happens later

PCGA may contact you for identity, income, asset, housing-history, or other eligibility verification. Do not send sensitive documents until staff provides an approved secure method.

Comments or additional information

Step 6

Review and certify.

Applicant release and certification

I understand that the information in this initial application will be used to evaluate housing eligibility and establish the date and time received. I authorize PCGA to contact me about verification requirements. I certify that the information I provided is true and complete to the best of my knowledge.

I agree and certify the information above. Required

Type the primary applicant’s full name as a signature RequiredBy typing your full name, you agree that it acts as your legal signature for this application.

Before submitting: Review your information carefully. Your application number will appear after the application is received.