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Preliminary Housing Application

  1. Preliminary Housing Application - Placement on Housing Registry
  2. Rentals or Homeownership
    Are you interested in rentals or homeownership?
  3. How many bedrooms and bathrooms would you like to have?
  4. How many people will live in the residence?
  5. Household Income*
    Based on your most recent tax return, what is your approximate annual household income?
  6. Age 55 or Older*
  7. US Veteran*
  8. Police / Fire / EMS*
  9. Town of Southold Affordable Housing Registry
    Please note that placement on the Town of Southold Affordable Housing Registry in no way should be construed as a representation to placement, availability or offering of affordable housing in the Town of Southold. Parties completing this application are doing so under no promise of the same. Applicants specifically understand that no representations, guarantees or warranties of any nature whatsoever have been made in conjunction with this application.
  10. Leave This Blank:

  11. This field is not part of the form submission.