INTRODUCTION   

The mission of Ark House is to provide low-cost temporary housing for out of town patients and their families while undergoing extended medical treatment in the Dallas area.

Ark House (AH) leases apartments on a long-term basis and sub-leases those apartments at a substantial discount to out of town patients temporarily while they undergo extended medical care away from their home. The Occupancy Agreements (sub-leases) require a minimum of seven (7) day stay and expire at 90-days. The Occupancy Agreements may be extended at Ark House discretion based on re-certification of medical need, timely payment of rent, and appropriate occupant behavior. As these apartments are not intended as a permanent residence, extension beyond 360 days is rare.

Please understand that Ark House maintains a waitlist and may not be able to accept new occupants at your exact time of need. 

QUALIFICATIONS FOR ARK HOUSE

    • Must be referred by medical facility staff where the patient is actively receiving extended medical treatment. Referral must include a general description of ailment and expected duration of stay
    • Patient’s permanent residence must be more than fifty (50) miles from Dallas as defined by Google maps.
    • Ark House does NOT submit insurance claims for covered housing. Receipts will be provided.
    • NO pets permitted
    • Only two (2) occupants 18 years of age or older may occupy Ark House at the same time
    • No criminal history. 
  • All occupants 18 years of age, or older, must have a credit and criminal background check prior to being accepted for occupancy. There is a nonrefundable $20.00 fee for the first occupant’s background check. Ark House will pay for the other occupants listed on the application.
    • Applicants will be automatically denied residency if charged or convicted of a felony or most misdemeanors prior to or during occupancy involving but not limited to violent crimes, property damage, possession, manufacturing and/or distribution of a controlled substance, registered sex offenders and sexual offenses, prostitution, burglary, theft, fraud or crimes against children and/or injury to a person by bodily harm.
    • U.S. Citizens — Social Security Numbers (SSN’s) and Email addresses for each occupant are REQUIRED 
  • Non-U.S. Citizens — Papers showing legal entry to the United States and Email Addresses for each occupant are REQUIRED. Each Non-U.S. citizen must fill out a Supplemental International Application and provide a copy of relative documents. Contact Occupancy at (972) 671-7144 or Occupancy@ArkHouseDallas.org to obtain the appropriate form.

COST

    • Due at move-in (for example Tuesday move-in = $408.00)
      • Security Deposit – $100.00 (refundable if apartment left clean and in good condition)
      • A partial weeks rent (four days) at $28.00 per day prorated for days until Friday (Tuesday move-in is four days until Friday or $112.00)
      • Second weeks rent at $28.00 per day or $196.00
    • Third and subsequent weeks rent are due on following Fridays paid one week in advance
    • All payments must be made by credit or debit card to be automatically charged by Ark House
    • Utilities are paid by Ark House. No phone or WIFI included. Cell phones must be provided by the occupant(s), if needed.
  • There is no penalty for the occupant terminating the Occupancy Agreement after seven (7) days. However, the occupant must notify Ark House in writing, by email, or phone prior to moving out. Failure to notify Ark House of moving out will result in daily rent continuing until Ark House determines that you have moved out and you will also forfeit (lose) your security deposit.

APPLICATION TO ARK HOUSE

  1. Medical facility staff MUST refer the patient to Ark House as a prospective occupant. Typically a Social Worker or Case Manager.
    • On receipt of the referral, an Ark House representative will contact the applicants to explain Ark House. The patient or their representative will be asked to complete all steps of this application process within seven (7) days! Failure to complete the application process within seven (7) days will remove the patient from consideration for Ark House!

  2. Patient or their representative must complete this ArkHouse application and the credit/debit card authorization for the background checks all persons over 17 years of age, including patient, is required to pass a background check.

     

  3. Patient or their representative must submit cell phone photos or other legible/readable images of each occupant’s government-issued photo ID to Ark House by sharing via text to (972)671-7144 or by email to occupancy@ArkHouseDallas.org. If you, or another occupant, are not a U.S. citizen, photos of the US Government document(s) allowing you entry to the U.S. must be provided

In fairness to all concerned, the patient will NOT be placed on the Ark House waitlist unless the following is completed within seven (7) days of contact from Ark House following referral: 

  1. Referral from the medical facility providing treatment.
  2. This application is completed with credit/debit card authorization for background checks.
  3. Legible photos of Government-issued photo IDs are received by Ark House.
  4. Background checks have been completed. 
  5. Background checks have been reviewed and approved by Ark House.

Once on the waitlist, it is the patient’s, or their representative’s, responsibility to keep Ark House informed about their need date for an apartment by coordinating with Ark house at (972) 671-7144 or by email to occupancy@arkhousedallas.org. We understand that you are not in total control of the timing for your need for lodging. You must also understand that Ark House has limited resources, apartments, and personnel and that Ark House can not guarantee an apartment will be available at your time of need

    ARK HOUSE APPLICATION

    A member of your family or a friend has been referred to Ark House by a medical facility providing treatment. This application is required to start the process of qualification for Ark House. The patient or their representative should have been or will be contacted by an Ark House representative to coordinate the application process.

    In fairness to all concerned, the patient will NOT be placed on the Ark House waitlist unless the following is completed within SEVEN (7) DAYS OF INITIAL CONTACT from Ark House following referral:

    This application is NOT complete without:
    1. Credit/debit card authorization for background checks.
    2. Legible photos of Government-issued photo IDs and all required documents are received by Ark House.
    3. Until background checks have been completed and application is approved by Ark House.

    =======================
    INSTRUCTIONS:
    Many fields in this form are REQUIRED.
    * Required Information
    ** Required if you have one!
    The required fields are noted with an "*" next to the field name. If the information in the required field is not applicable, you may enter "NA".
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    ======= PATIENT =======

    Please NOTE:
    The following information for the PATIENT is required even if they may not initially be staying in Ark House! Information on occupants other than the patient will be entered later in the form.

    FULL LEGAL NAMES are required for background checks! NO Nicknames. Thank You.

    GENDER: (Male/Female)

    PERMANENT HOME ADDRESS - WHERE YOU LIVE NOW:

    STATE*:

    DO YOU OWN OR RENT?* RentOwn

    Enter Date of Birth:
    Birth Month:* (Month: 1 to 12)
    Birth Day.....:* (Day: 1 to 31)
    Birth Year....:* (Year: 1910 to 2040)

    SOCIAL SECURITY NUMBER (SSN)**: (Enter "None" if person does not have a SSN)

    DRIVER'S LICENSE or Govt ID NUMBER*:

    U.S. CITIZEN*:


    MUST BE IN THE U.S. LEGALLY with documents to reside in Ark House.
    Legally in the U.S.?:

    Applicants must email copy of documents showing legal residence in the United States to Ark House at OCCUPANCY@ARKHOUSEDALLAS.ORG immediately after submitting application. Use your phone to take picture of document(s) and forward by email.

    A PERSON ILLEGALLY IN THE UNITED STATES MAY NOT STAY AT ARKHOUSE! Criminal background check can not be performed. Call Occupancy at (972) 671-7144 for additional information or clarification


    DO YOU SMOKE*: YesNo

    Smoking in Ark House apartment or other buildings is grounds for eviction!



    === OCCUPANT #2 / CAREGIVER ===
    ADD 2nd OCCUPANT?:

    FULL LEGAL NAMES are required for background checks! NO Nicknames. Thank You."

    GENDER: (Male/F-Female)



    Relationship to Patient:

    PERMANENT HOME ADDRESS - WHERE YOU LIVE NOW:

    STATE*:

    DO YOU OWN OR RENT?* RentOwn

    Enter Date of Birth:
    Birth Month:* (Month: 1 to 12)
    Birth Day.....:* (Day: 1 to 31)
    Birth Year....:* (Year: 1910 to 2040)

    SOCIAL SECURITY NUMBER (SSN)**: (Enter "None" if person does not have a SSN)

    DRIVER'S LICENSE or Govt ID NUMBER*:

    U.S. CITIZEN*:


    MUST BE IN THE U.S. LEGALLY with documents to reside in Ark House.
    Legally in the U.S.?:

    Applicants must email copy of documents showing legal residence in the United States to Ark House at OCCUPANCY@ARKHOUSEDALLAS.ORG immediately after submitting application. Use your phone to take picture of document(s) and forward by email.

    A PERSON ILLEGALLY IN THE UNITED STATES MAY NOT STAY AT ARKHOUSE! Criminal background check can not be performed. Call Occupancy at (972) 671-7144 for additional information or clarification



    DO YOU SMOKE*: YesNo

    Smoking in Ark House apartment or other buildings is grounds for eviction!



    === OCCUPANT #3 / CAREGIVER ===
    ADD 3rd OCCUPANT?:

    FULL LEGAL NAMES are required for background checks! NO Nicknames. Thank You."

    GENDER: (Male/F-Female)



    Relationship to Patient:

    PERMANENT HOME ADDRESS - WHERE YOU LIVE NOW:

    STATE*:

    DO YOU OWN OR RENT?* RentOwn

    Enter Date of Birth:
    Birth Month:* (Month: 1 to 12)
    Birth Day.....:* (Day: 1 to 31)
    Birth Year....:* (Year: 1910 to 2040)

    SOCIAL SECURITY NUMBER (SSN)**: (Enter "None" if person does not have a SSN)

    DRIVER'S LICENSE or Govt ID NUMBER*:

    U.S. CITIZEN*:


    MUST BE IN THE U.S. LEGALLY with documents to reside in Ark House.
    Legally in the U.S.?:

    Applicants must email copy of documents showing legal residence in the United States to Ark House at OCCUPANCY@ARKHOUSEDALLAS.ORG immediately after submitting application. Use your phone to take picture of document(s) and forward by email.

    A PERSON ILLEGALLY IN THE UNITED STATES MAY NOT STAY AT ARKHOUSE! Criminal background check can not be performed. Call Occupancy at (972) 671-7144 for additional information or clarification



    DO YOU SMOKE*: YesNo

    Smoking in Ark House apartment or other buildings is grounds for eviction!


    === OCCUPANT #4 / CAREGIVER ===
    ADD 4th OCCUPANT?:

    FULL LEGAL NAMES are required for background checks! NO Nicknames. Thank You."

    GENDER: (Male/F-Female)



    Relationship to Patient:

    PERMANENT HOME ADDRESS - WHERE YOU LIVE NOW:

    STATE*:

    DO YOU OWN OR RENT?* RentOwn

    Enter Date of Birth:
    Birth Month:* (Month: 1 to 12)
    Birth Day.....:* (Day: 1 to 31)
    Birth Year....:* (Year: 1910 to 2040)

    SOCIAL SECURITY NUMBER (SSN)**: (Enter "None" if person does not have a SSN)

    DRIVER'S LICENSE or Govt ID NUMBER*:

    U.S. CITIZEN*:


    MUST BE IN THE U.S. LEGALLY with documents to reside in Ark House.
    Legally in the U.S.?:

    Applicants must email copy of documents showing legal residence in the United States to Ark House at OCCUPANCY@ARKHOUSEDALLAS.ORG immediately after submitting application. Use your phone to take picture of document(s) and forward by email.

    A PERSON ILLEGALLY IN THE UNITED STATES MAY NOT STAY AT ARKHOUSE! Criminal background check can not be performed. Call Occupancy at (972) 671-7144 for additional information or clarification



    DO YOU SMOKE*: YesNo

    Smoking in Ark House apartment or other buildings is grounds for eviction!



    YesNo ... been evicted or asked to move out?
    YesNo ... left before lease expired without the owner's consent?
    YesNo ... declared bankruptcy?
    YesNo ... been sued for rent?
    YesNo ... been sued for property damage?>
    YesNo ... been convicted or received probation for a felony or misdemeanor crime?
    For any "YES" above, indicate below the person(s) who was responsible, year, location, and type of each felony or misdemeanor crime.

    ======= EMERGENCY CONTACT (Not Residing at Ark House) =======

    RELATIONSHIP (required):

    ======= GOVERNMENT ISSUED ID - SEND NOW =======

    Provide a photographic image (PNG or JPG) or photo of all persons listed on this application. It must be a valid (NOT Expired) driver's license or government-issued photo ID. Please confirm that the ID image is in focus and readable and the photo is recognizable. Email to occupancy@arkhousedallas.org or text to Ark House Occupancy at (972) 671-7144.

    ======= AUTHORIZATION =======

    I, the undersigned, have obtained permission from all applicant to authorize Ark House to obtain reports from any consumer or criminal record reporting agencies before, during, and after residency on matters relating to a lease by Ark House to me and to verify, by all available means, the information in this Application, including criminal background information, income history and other information reported by employer(s) to any state employment security agency. Work history information may be used only for this Application. Authority to obtain this information expires 365 days from the date of this Application.

    ======= ACKNOWLEDGEMENT =======

    You declare that all your statements in this Application are true and complete. Applicant's submission of this Application, including payment of any fees and deposits, is being done only after the applicant has fully investigated, to its satisfaction, those facts which applicant deems material and necessary to the decision to apply for a rental unit. You authorize AH to verify your information through any means, including consumer-reporting agencies and other rental-housing owners. You acknowledge that you had an opportunity to review our rental-selection criteria, which include reasons your Application may be denied, such as criminal history, credit history, current income, and rental history. You understand that if you do not meet our rental-selection criteria or if you fail to answer any question or give false information, we may reject the Application, retain all application fees as liquidated damages for our time and expense, and terminate your right of occupancy. Giving false information is a serious criminal offense. In lawsuits relating to the Application or Lease, the prevailing party may recover from the non-prevailing party all attorney's fees and litigation costs. We may at any time furnish information to consumer-reporting agencies and other rental-housing owners regarding your performance of your legal obligations, including both favorable and unfavorable information about your compliance with the Lease, the rules, and financial obligations. Fax or electronic signatures are legally binding. We do not sell your information or provide it to third parties for any purpose not directly related to this application.

    Right to review the Lease. Before you submit an Application or pay any fees or deposits, you have the right to review the Application and Lease, as well as any community rules or policies we have. You may also consult an attorney. These documents are binding legal documents when signed. We will not take a particular dwelling off the market until we receive a completed Application and any other required information or monies to rent that dwelling.

    Additional provisions or changes may be made in the Lease if agreed to in writing by all parties. You are entitled to a copy of the Lease when it is fully signed.

    Images on the apartment and/or the Ark House website represent a sample of a unit and may not reflect specific details of any unit. For information not found on our web-site regarding availability, unit characteristics or other questions, please call Ark House at (972) 671-7144.

    THIS APPLICATION IS NOT COMPLETE UNTIL THE LEGIBLE PHOTO ID’S FOR EACH OCCUPANT IS RECEIVED BY ARK HOUSE AT OCCUPANCY@ARKHOUSEDALLAS.ORG OR BY ATTACHMENT TO A TEXT MESSAGE SENT TO (972) 671-7144.

    This Application and the Lease are binding documents when signed. Before submitting an Application or signing a Lease, you may make a copy of these documents to review and/or consult an attorney. Additional provisions or changes may be made in the Lease ONLY if agreed to in writing by all parties.

    PLEASE SIGN IN THIS BOX:

    ======= WHO FILLED OUT THIS FORM? =======

    =======================
    INSTRUCTIONS:
    After reviewing the information entered above and checking the box above, you have completed the application form. Click the "SUBMIT APPLICATION" button to submit the application. Please remember the application is NOT complete until you submit photo ID's by sending via text message to (972) 671-7144. Also, you must complete the credit/debit card authorization.
    =======================

    AFTER SUBMITTING APPLICATION you will be directed to a new page to fill out the "Credit/Debit Card Authorization".