Apply - St. Michael Terrace

Thank you for your interest in St. Michael Terrace. The US Department of Agriculture Rural Development governs us. Our facility is available to qualified elderly, handicapped, and disabled residents. Effective April 1, 2024, for eligible households, our apartments rent for the following:

30% of households' adjusted (after medical expenses) monthly income
Or when rental assistance is not available - a 1-bedroom basic rental rate of $617 per month less a $70 utility allowance (or 30% of household's adjusted monthly income if higher than basic rent)
Or when rental assistance is not available - the 2-bedroom basic rental rate of $654 per month less a $99 utility allowance (or 30% of household's adjusted income if higher than basic rent)

St. Michael Terrace maintains a waiting list for housing. The waiting list is based on annual adjusted income, and selection is chronological with the priority given to very low-income applicants. The First step towards housing begins with completion of the Application for Residency accompanied by a copy of your photo ID. If qualified, the applicant is then assigned to the appropriate income level on our waiting list.

Our lease run for a yearly period and are required to be updated annually with Rural Development.

Below is an Application for Residency. It is important that you complete the form accurately in order for us to have the necessary information to determine your qualification and placement on the waiting list.

In accordance with Federal law and the US Dept. of Agriculture policy, this institution is prohibited from discrimination on the basis of race, color, national origin, sex, or disability. (Not all prohibited bases apply to all programs). To file a complaint of discrimination, write USDA, Director Office of Civil Rights, 1400 Independence Ave., S.W., Washington D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD).

Sincerely,

Brenda Reitz

Property Manager

GLOWACKI MANAGEMENT, INC.

Please Note: Residents of St. Michael Terrace are required to pay their own electric bill for their apartment. However, a $70 per month energy credit is deducted from the calculated rent.

An applicant may be interviewed only after a completed application is received. Completed applications are processed in order of date and time received. You may contact the rental office for assistance in completing the application.

To Print and Mail your application, click below:

1General Information

2References

3Income

4Assets

5Expenses

6Program Information

7Other Information

8Certification

9Authorization for Release of Information

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

List(Required)

Name

Relationship to Head

DOB

Sex

Social Security Numbers need to be provided by calling (814) 371-1200. We do not collect them online for your protection.

Is anyone in this household a full-time student?(Required)

Yes

No

If you are not 62 years old or older, are you applying for residency based on your status as an individual with a handicap or disability?(Required)

Yes

No

If "Yes", indicate which family member is disabled

Does your disability require a handicapped or mobility impaired unit?(Required)

Yes

No

Current Landlord

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Previous Landlord

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Non-related Personal References

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Credit References

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Checking Acounts

Bank

Balance

Bank

Balance

Savings Accounts

Bank

Balance

Bank

Balance

Money Market Account(s)

Bank

Balance

Trust Account(s)

Bank

Balance

Certificates of Deposit

Bank

Balance

IRA

Company

Balance

Savings Bond(s)

Cash Value

Whole Life Ins. Policy

Cash Value

Real Property

Do you own any property?(Required)

Yes

No

If you, state type of property

Address

Street Address Address Line 2 City State ZIP Code

Current Market Value

Outstanding Mortgage Balance

Have you sold/disposed of any business, property or other assets in the last 2 years?

Yes

No

Other

If yes, state type of business, property or assets

Date

Market value when sold/disposed of

Amount sold/disposed for

Do you have any other assets not listed above (i.e. recreational vehicle or mobile home; do not include personal property)?(Required)

Yes

No

If yes, please list

Medical Expenses

Complete this part ONLY if head of household or spouse is 62 or older, handicapped or disabled.

Medicare Premiums

Medical Insurance Coverage

Name of Company

Address

Street Address Address Line 2 City State ZIP Code

Anticipated Medical Expenses NOT Covered by insurance nor reimbursed

Medical Bills or outstanding costs on which you are making monthly payments

Medical Related Travel Costs

Any other medical expenses: list type

Other Medical Expenses

Child Care Expenses

Complete this part for household minors under 13 ONLY.

Name of Child cared for

Age

Name of child cared for

Age

Name of person/agency caring for children

Address

Street Address Address Line 2 City State ZIP Code

Phone

Weekly cost of child care due to employment

Weekly cost of child care due to education

CERTIFICATION

I/We herby certify that the unit applied for will be the household's permanent residence.
I/We further certify that I/we do/will not maintain a separate subsidized rental unit in another location.
I/We understand that I/we must pay a security deposit for this unit.
I/We understand that my/our eligibility for housing will be based on USDA-Rural Development income limits and tenant selection criteria.
I/We certify that all information in this application is true to the best of my/our knowledge and understand that false statements or information are punishable by law and will lead to cancellation of this application or termination of tenancy after occupancy.

Signature(Required)

Date(Required)

Signature

Date

ID Card(Required)

Drop files here or

Max. file size: 256 MB, Max. files: 2.

Please upload a picture of your ID Card

"The information regarding race, ethnicity and sex designation solicited on this application is request in order to assure the Federal Government, acting through the Rural Housing Service, that the Federal laws prohibiting discrimination against tenant application 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

Hispanic or Latino

Yes

No

Race

American Indian/Alaska Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

White

SMOKING/NON-SMOKING POLICY I understand that as of August 3, 2028, St. Michael Terrace has implemented a policy that bars the use of prohibited tobacco products in all public housing units, interior common areas, and outdoor areas within 25 feet of public housing and administrative office buildings. Prohibited tobacco products are defined as items that involve the ignition and burning of tobacco leaves, such as cigarettes, cigars, pipes and water pipes (:also known as hookahs).
All residents, guests, employees and vendors will no longer be permitted to smoke in or within 25 feet of St. Michael Terrace.
Furthermore, I understand that there are no separate/covered outside areas designated for smoking.

Authorization for Release of Information

I/We, herby authorize Glowacki Management, Inc; c/o St. Michael Terrace, 111 West Long Avenue, DuBois, PA 15801 and its staff or authorized representatives, to contact any agencies, offices, financial institutions, groups, organizations, or individuals to obtain and verify any information or materials which are deemed necessary to process and complete my application or annual income recertification and rent determination, as required by Federal regulations and program requirements, for the following programs:

USDA rent subsidy program
Rent Supplements
Section 236

Rent Assistance Payments (RAP)
Section 8 Housing Assistance
Section 515 Housing Assistance

I also give my consent for the releases for any minor children in my care who are living with me.

Resident Signature(Required)

Date(Required)

Co-Resident Signature

Date

Apply Now

To Print and Mail your application, click below:

Current Landlord

Previous Landlord

Non-related Personal References

Credit References

Wages

County Assistance (welfare payments), cash only

Social Security (before Medicare deduction)

SSI Benefits

Veterans Benefits

Pension(s)

Unemployment Comp.

AFDC

Alimony

Child Support

Full Time Student Income (Only Full-time students 18 & Over)

Total

Checking Acounts

Savings Accounts

Money Market Account(s)

Trust Account(s)

Certificates of Deposit

IRA

Savings Bond(s)

Whole Life Ins. Policy

Real Property

Medical Expenses

Child Care Expenses

List all cars, trucks or other vehicle owned.

Pets

CERTIFICATION

Ethnicity

Authorization for Release of Information