Baker's Dozen Vacancy Application

Thank you for taking the time to apply to live in the Baker's Dozen collective home!

Before you begin, please make sure you have read the Baker Dozen's information sheet with critical information about responsibilities for living in the house, monthly and move-in costs, maximum income requirements (also listed below) and other key details about the selection process: C lick here to view

Household Size	1-person household	2-person household
50% Area Median Income	$68,550	$78,350

We will have interviews in the month before move-in and will schedule with eligible applicants; finalists will need to be able to attend an 45 minute interview to be considered.

If you have any accessibility needs in relation to filling out this form, please email us at housing@nclt.org and we will work to make the application accessible to you. Additionally, we have paper copies of the application available if you do not have access to a printer and/or want to fill it out by hand. Please email us to schedule a time to pick up a hard copy or have us mail you a hard copy. All applications will be submitted to the Northern California Land Trust who will verify applicant's income and preference information and support Baker's Dozen in the selection process.

Our building is owned and managed by the Northern California Community Land Trust (NCLT).

Applicant Name

Edit this text

Current Mailing Address (street and number)

Phone

City, State

Email

Zip

Do you currently reside at Mailing Address Listed Here

YesNo

Please provide the following information for the past 3 years of residence: Address(es), Move-in date(s), move out date(s), reason(s) for moving, owner name(s), owner phone number(s) - PLEASE PROVIDE ALL REQUESTED INFORMATION

HOUSEHOLD INFORMATION (Please list all members of the household that are applying for this vacancy, including yourself)

	Name	Gender	Pronoun	Relationship to Applicant

FINANCIAL INFORMATION

Household Member Name

Employer Name

Employer Address

Employer Phone

State

Position Title

Start Date:

End Date:

Gross Monthly Income

Pay Cycle

Bi-MonthlyMonthlyOther

OTHER INCOME (Please list other income for all members of the household. Please include SSI, AFDC, alimony, etc.)

	Name	Source	Gross Monthly Income

Total Adjusted Gross Annual Income for 2024 from tax return

Total Adjusted Gross Annual Income for 2023 from tax return

Total Adjusted Gross Annual Income for 2022 from tax return

If you have not filed a recent tax return, please explain why and offer alternative documentation of income, if possible.

FINANCIAL DOCUMENTATION

Documents to prove your income and eligibility. Without these documents, your application will be incomplete. Please attach all of the following:

A government issued photo ID or other acceptable form of verification of identity
Income Documentation:

Three most recent pay stubs and/or benefit statements for all adult household members. If self-employed, please include accounts that show your income for the past 3 months.
Your most recent Federal Tax Return and tax ID or social security number (or an an explanation for why you have not filed) for all adult household members
A recent credit report with credit score for all potential household leaseholders

ASSETS

Please indicate type of assets and amounts for all adult members of household

	TOTAL ASSET VALUE	AVAILABLE FUNDS	INSTITUTION NAME
Cash
Checking Account
Checking Account
Savings Account
Savings Account
Retirement Account
Money Market/Mutual Fund
Other

HOUSING INFORMATION

Please read and certify that you have read the Baker's Dozen information sheet

Yes, I have read the Baker's Dozen information sheet

Do you have Section 8?

YesNo

If yes on Section 8, with which Housing Authority (which city) is your housing certificate?

How did you hear about Baker's Dozen?

Are you bringing pets? If yes, what kind?

Do you qualify for any of the below County and City of San Francisco Preferences?

YesNo

1 - Certificate of Preference (COP) - Certificate of Preference holders who were displaced in the 1960’s and early 1970’s by the San Francisco Redevelopment Agency. City & County of San Francisco’s Mayor’s Office of Housing & Community Development administers this program and NCLT will verify such Certificate of Preference holders.

2 - Displaced Tenant Housing Preference (DTHP) - Displaced Tenant Housing Preference Certificate holders who have been displaced or at risk of displacement due to withdrawal of their housing unit from the rental market by an Ellis Act or Owner Move In eviction. NCLT will verify Certificate holders with the City & County of San Francisco’s Mayor’s Office of Housing & Community Development who administers this program.

3 - Live or Work in San Francisco (L/W)- Applicants that currently reside or work in the City and County of San Francisco. Applicants must submit proof with their application in order to claim this preference; feel free to attach that proof below.

NARRATIVE QUESTIONS

The minimal requirements to live here include: attend meetings every 1st and 3rd Sundays of each month 10am-12pm, cook dinner once a month, do weekly chores, and be on two committees. Each person is required to clean up after themself when using common space. Please confirm that you understand and can commit to ALL of these REQUIREMENTS.

I understand and commit to all of these requirements

YesNo

Do you have any concerns about your capacity to fulfill house commitments? How would you like to be held accountable to these commitments?

How do you navigate common spaces in a shared household?

What do you seek in a home?

How does your identity and life experience affect the way you see the world?

What are your experiences in navigating difference?

What is your experience with group decision-making and collective projects? What do you like and what is challenging for you?

Do you have experience with consensus and with conflict resolution? If yes, please share.

Are you involved in community organizations or events? If so, which one(s) and how?

What special skills would you bring to Baker's Dozen?

Do you have experience living in a diverse environment with Queer, Trans, POC, and seniors? How do you feel about living in a diverse environment with people of different sexual orientations, gender identities, cultural backgrounds, ages, and abilities?

How long, if qualified and selected, do you plan to live at Baker's Dozen?

If there is anything else you think we should know about your background, housing situation, financial situation, or about any other special circumstances, please include here.

Baker's Dozen House does not discriminate on the basis of marital status, race, religion, ancestry, gender, sexual orientation, age, national origin, HIV or HIV-related conditions, physical handicap or any other arbitrary basis.