I understand that CCLT requests this information as part of the preliminary application. Some information is being obtained for statistical purposes only. CCLT is an equal opportunity housing provider and does not discriminate on the basis of race, color, national origin, religion, sex, age, disability, family status, or any other basis prohibited by law in the administration of programs and activities.

All CCLT services are implemented in compliance with Title VI of the Civil Rights Act of 1964; Title II of the Americans with Disabilities Act of 1990; Title VIII of the Civil Rights Act of 1968, as amended; Section 504 of the Rehabilitation Act of 1973, as amended; the Fair Housing Amendments Act of 1988; and all other applicable Civil Rights and Fair Housing requirements. If you believe you have been discriminated against, you may call:

CCLT Housing Office
2424 McElderry St.
Baltimore, MD 21205
410-220-8074

You may also contact one of the following agencies:

Baltimore Neighborhoods, Inc.
PHONE: 410-243-4400

Maryland Commission on Human Rights
PHONE: 410-767-8600
TTY: 410-333-1737

U.S. Department of Housing and Urban Development
PHONE: 410-962-2520, Ext. 3056
TTY: 410-962-0106

Baltimore Community Relations Commission
PHONE: 410-396-3141

By signing below and submitting this application, I/we certify that the information given to CCLT in this application is accurate and complete to the best of my/our knowledge and belief. I/we understand that false statements or information are punishable under federal law and ground for CCLT to deny housing assistance.

I/we also understand that a criminal background check will be performed for members of my/our household fourteen (14) years and older according to federal law.