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Costa Mesa Rental Housing Affordability Survey
77 Fair Drive, Costa Mesa, CA 92626
1.
Do you rent a residence in the City of Costa Mesa?
Yes
No
2.
Is your annual income (from all sources) LESS THAN the amount listed for your household size below?
Annual income is the gross amount of income of all adult household members that is anticipated to be received during the coming 12-month period.
Yes
No
3.
What is your household size?
1
2
3
4
5+
4.
Are there minor children (under age 18) in your household?
Yes
No
5.
Do you pay 50% or more of your monthly income toward housing costs (rent plus gas, electricity, water and sewer)?
For Example:
If you pay $1,000 or more for housing costs (rent+gas+electricity+water) and you have a $2,000 monthly income, then you pay 50% or more of your monthly income toward housing costs and would answer "yes" below.
Yes
No
6.
If you could receive rental assistance, paid directly to your landlord, to reduce your rent to 30% of your monthly income for up to 24 months, would you apply?
Using the income and rent amounts listed "For Example" in question 5, you would be responsible for $600 of the total rent of $1,000 each month that you are eligible for the assistance.
Yes
No
7.
If you would like to be notified of rental assistance opportunities through the City of Costa Mesa when they are available, please provide your contact information below (name and address, phone, or email).
Name
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
