diff --git a/shared-helpers/index.ts b/shared-helpers/index.ts
index 42da2f1e86..6adfb676e6 100644
--- a/shared-helpers/index.ts
+++ b/shared-helpers/index.ts
@@ -16,6 +16,7 @@ export * from "./src/utilities/stringFormatting"
 export * from "./src/utilities/token"
 export * from "./src/utilities/unitTypes"
 export * from "./src/utilities/DateFormat"
+export * from "./src/utilities/constants"
 export * from "./src/views/multiselectQuestions"
 export * from "./src/views/occupancyFormatting"
 export * from "./src/views/summaryTables"
diff --git a/shared-helpers/src/locales/general.json b/shared-helpers/src/locales/general.json
index 0dc9fdea05..e72dca11fc 100644
--- a/shared-helpers/src/locales/general.json
+++ b/shared-helpers/src/locales/general.json
@@ -316,6 +316,9 @@
   "application.preferences.neighborhoodResidence.neighborhoodResidence.label": "Neighborhood Residents Preference",
   "application.preferences.neighborhoodResidence.title": "Neighborhood Residents",
   "application.preferences.options.address": "Address",
+  "application.preferences.options.qualifyingAddress": "Qualifying Address",
+  "application.preferences.options.addressHolderName": "Full Name of Address Holder",
+  "application.preferences.options.addressHolderRelationship": "Relationship to Address Holder",
   "application.preferences.options.organization": "Name of Organization",
   "application.preferences.preamble": "If you qualify for this preference, you'll get a higher ranking.",
   "application.preferences.rosefieldAUSD.title": "Alameda Unified School District (AUSD) employee",
diff --git a/shared-helpers/src/utilities/constants.ts b/shared-helpers/src/utilities/constants.ts
new file mode 100644
index 0000000000..ee2b199380
--- /dev/null
+++ b/shared-helpers/src/utilities/constants.ts
@@ -0,0 +1,4 @@
+export enum AddressHolder {
+  Relationship = "addressHolderRelationship",
+  Name = "addressHolderName",
+}
diff --git a/shared-helpers/src/views/multiselectQuestions.tsx b/shared-helpers/src/views/multiselectQuestions.tsx
index 9cd6c7512f..50cf9c6fff 100644
--- a/shared-helpers/src/views/multiselectQuestions.tsx
+++ b/shared-helpers/src/views/multiselectQuestions.tsx
@@ -1,24 +1,25 @@
 import * as React from "react"
 import {
-  InputType,
-  MultiselectQuestion,
-  MultiselectOption,
   ApplicationMultiselectQuestion,
   ApplicationMultiselectQuestionOption,
   ApplicationSection,
-  ListingMultiselectQuestion,
+  InputType,
   Listing,
+  ListingMultiselectQuestion,
+  MultiselectOption,
+  MultiselectQuestion,
 } from "@bloom-housing/backend-core/types"
 import { UseFormMethods } from "react-hook-form"
 import {
-  t,
-  Field,
-  resolveObject,
-  FormAddress,
   ExpandableContent,
+  Field,
   FieldGroup,
+  FormAddress,
+  resolveObject,
+  t,
 } from "@bloom-housing/ui-components"
 import { stateKeys } from "../utilities/formKeys"
+import { AddressHolder } from "../utilities/constants"
 
 export const listingSectionQuestions = (
   listing: Listing,
@@ -235,7 +236,6 @@ export const getCheckboxOption = (
           exclusiveKeys
         )}
       </div>
-
       {option.description && (
         <div className="ml-8 -mt-5 mb-5">
           <ExpandableContent strings={{ readMore: t("t.readMore"), readLess: t("t.readLess") }}>
@@ -257,11 +257,41 @@ export const getCheckboxOption = (
           </ExpandableContent>
         </div>
       )}
-
+      {watchFields[optionFieldName] && option.collectName && (
+        <Field
+          id={AddressHolder.Name}
+          name={`${optionFieldName}-${AddressHolder.Name}`}
+          label={t(`application.preferences.options.${AddressHolder.Name}`)}
+          register={register}
+          validation={{ required: true, maxLength: 64 }}
+          error={!!resolveObject(`${optionFieldName}-${AddressHolder.Name}`, errors)}
+          errorMessage={
+            resolveObject(`${optionFieldName}-${AddressHolder.Name}`, errors)?.type === "maxLength"
+              ? t("errors.maxLength")
+              : t("errors.requiredFieldError")
+          }
+        />
+      )}
+      {watchFields[optionFieldName] && option.collectRelationship && (
+        <Field
+          id={AddressHolder.Relationship}
+          name={`${optionFieldName}-${AddressHolder.Relationship}`}
+          label={t(`application.preferences.options.${AddressHolder.Relationship}`)}
+          register={register}
+          validation={{ required: true, maxLength: 64 }}
+          error={!!resolveObject(`${optionFieldName}-${AddressHolder.Relationship}`, errors)}
+          errorMessage={
+            resolveObject(`${optionFieldName}-${AddressHolder.Relationship}`, errors)?.type ===
+            "maxLength"
+              ? t("errors.maxLength")
+              : t("errors.requiredFieldError")
+          }
+        />
+      )}
       {watchFields[optionFieldName] && option.collectAddress && (
         <div className="pb-4">
           <FormAddress
-            subtitle={t("application.preferences.options.address")}
+            subtitle={t("application.preferences.options.qualifyingAddress")}
             dataKey={fieldName(question.text, applicationSection, `${option.text}-address`)}
             register={register}
             errors={errors}
@@ -317,18 +347,41 @@ export const mapCheckboxesToApi = (
   const claimed = !!Object.keys(data).filter((key) => data[key] === true).length
 
   const addressFields = Object.keys(data).filter((option) => Object.keys(data[option]))
-
   const questionOptions: ApplicationMultiselectQuestionOption[] = Object.keys(data)
     .filter((option) => !Object.keys(data[option]).length)
     .map((key) => {
+      const extraData = []
       const addressData = addressFields.filter((addressField) => addressField === `${key}-address`)
+      const addressHolderNameData = addressFields.filter(
+        (addressField) => addressField === `${key}-${AddressHolder.Name}`
+      )
+      const addressHolderRelationshipData = addressFields.filter(
+        (addressField) => addressField === `${key}-${AddressHolder.Relationship}`
+      )
+      if (addressData.length) {
+        extraData.push({ type: InputType.address, key: "address", value: data[addressData[0]] })
+
+        if (addressHolderNameData.length) {
+          extraData.push({
+            type: InputType.text,
+            key: AddressHolder.Name,
+            value: data[addressHolderNameData[0]],
+          })
+        }
+
+        if (addressHolderRelationshipData.length) {
+          extraData.push({
+            type: InputType.text,
+            key: AddressHolder.Relationship,
+            value: data[addressHolderRelationshipData[0]],
+          })
+        }
+      }
 
       return {
         key,
         checked: data[key] === true,
-        extraData: addressData.length
-          ? [{ type: InputType.address, key, value: data[addressData[0]] }]
-          : [],
+        extraData: extraData,
       }
     })
 
@@ -379,11 +432,24 @@ export const mapApiToMultiselectForm = (
     if (appQuestion.inputType === "checkbox") {
       options = question.options.reduce((acc, curr) => {
         const claimed = curr.checked
-
         if (appQuestion.inputType === "checkbox") {
           acc[curr.key] = claimed
           if (curr.extraData?.length) {
             acc[`${curr.key}-address`] = curr.extraData[0].value
+
+            const addressHolderName = curr.extraData?.find(
+              (field) => field.key === AddressHolder.Name
+            )
+            if (addressHolderName) {
+              acc[`${curr.key}-${AddressHolder.Name}`] = addressHolderName.value
+            }
+
+            const addressHolderRelationship = curr.extraData?.find(
+              (field) => field.key === AddressHolder.Relationship
+            )
+            if (addressHolderRelationship) {
+              acc[`${curr.key}-${AddressHolder.Relationship}`] = addressHolderRelationship.value
+            }
           }
         }
 
diff --git a/sites/public/src/components/shared/FormSummaryDetails.tsx b/sites/public/src/components/shared/FormSummaryDetails.tsx
index 54431c0e25..ae354a7f38 100644
--- a/sites/public/src/components/shared/FormSummaryDetails.tsx
+++ b/sites/public/src/components/shared/FormSummaryDetails.tsx
@@ -1,7 +1,7 @@
 import React, { Fragment, useEffect, useState } from "react"
 import { LocalizedLink, MultiLineAddress, t } from "@bloom-housing/ui-components"
 import { FieldValue } from "@bloom-housing/ui-seeds"
-import { getUniqueUnitTypes } from "@bloom-housing/shared-helpers"
+import { getUniqueUnitTypes, AddressHolder } from "@bloom-housing/shared-helpers"
 import {
   Address,
   AllExtraDataTypes,
@@ -88,21 +88,23 @@ const FormSummaryDetails = ({
     }
   }
 
-  const multiselectQuestionAddress = (extraData?: AllExtraDataTypes[]) => {
+  const multiselectQuestionHelpText = (extraData?: AllExtraDataTypes[]) => {
     if (!extraData) return
-    return extraData.reduce((acc, item) => {
+    const helperText = extraData.reduce((acc, item) => {
       if (item.type === InputType.address && typeof item.value === "object") {
-        acc += `
-          ${item.value.street}${!item.value.street2 && ","}
-          ${item.value.street2 ? `${item.value.street2},` : ""}
-          ${item.value.city},
-          ${item.value.state}
-          ${item.value.zipCode}
-          `
+        acc += `${item.value.street} ${!item.value.street2 ? "," : ""} ${
+          item.value.street2 ? `${item.value.street2},` : ""
+        } ${item.value.city}, ${item.value.state} ${item.value.zipCode}`
       }
 
       return acc
     }, "")
+
+    const name = extraData.find((field) => field.key === AddressHolder.Name)?.value as string
+    const relationship = extraData.find((field) => field.key === AddressHolder.Relationship)
+      ?.value as string
+
+    return `${name ? `${name}\n` : ""}${relationship ? `${relationship}\n` : ""}${helperText}`
   }
 
   const multiselectQuestionSection = (
@@ -134,10 +136,10 @@ const FormSummaryDetails = ({
                     .map((option: ApplicationMultiselectQuestionOption, index) => (
                       <FieldValue
                         label={question.key}
-                        helpText={multiselectQuestionAddress(option?.extraData)}
+                        helpText={multiselectQuestionHelpText(option?.extraData)}
                         key={index}
                         testId={"app-summary-preference"}
-                        className={"pb-4"}
+                        className={"pb-6 whitespace-pre-wrap"}
                       >
                         {option.key}
                       </FieldValue>
diff --git a/sites/public/src/lib/helpers.tsx b/sites/public/src/lib/helpers.tsx
index 6d3dd6cc4f..d2365920a4 100644
--- a/sites/public/src/lib/helpers.tsx
+++ b/sites/public/src/lib/helpers.tsx
@@ -202,7 +202,9 @@ export const untranslateMultiselectQuestion = (
 
           if (option.extraData) {
             option.extraData.forEach((extra) => {
-              extra.key = selectedOption.untranslatedText ?? selectedOption.text
+              if (!extra.key) {
+                extra.key = selectedOption.untranslatedText ?? selectedOption.text
+              }
             })
           }
         })