Preliminary Applicant Information and Income and Asset Disclosure for The Rose Affordable Senior Assisted Living Communities

This Preliminary Applicant Information and Income and Asset Disclosure form will permit the property manager to screen your eligibility for residing at the property. More detailed information and verifications will be required prior to your actual approval for residency. This prescreening is intended to allow you and the administrator to recognize immediately any issues of income eligibility that exist. Your cooperation will facilitate the processing of your application and will avoid surprises later in the process. As you complete this form, do not hesitate to contact us with any questions.