Affordable Housing

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HPNS

housing

The information contained within this form is being done so on a web site that is hosted outside of Canada. Nelson CARES Society is unable to confirm the security of this data and/or if this information is stored on this site and therefore outside the care, custody and control of Nelson CARES Society. Informed consent will be considered to have been given through the action of pressing the submit button. Should you not wish to submit this information electronically you are welcome to send this form via Canada Post or drop it by our office .

housing@nelsoncares.ca

APPLICATION FOR TENANCY

Who is Eligible

Affordable housing is available for families, singles, seniors, and persons living with disabilities who can live independently and qualify for a disability pension or who cannot work because of a disability.

Generally, people are eligible for housing if their household income falls below an amount set annually by BC Housing and their current rent exceeds 30 per cent of their income. As the demand for affordable housing is high, Nelson Affordable Housing assesses each applicant’s need for housing based on criteria which includes the applicant’s income, current living situation and personal and family requirements as compared to other applicants. This ensures that priority is given to households in the greatest need.

Purpose of this Form

This application form is designed to collect specific information from applicants seeking affordable housing in accordance with section 26 (c) of the Freedom of Information and Protection of Privacy Act (the FOI Act). Nelson Affordable Housing (referred to in this form as The Society) will use this information to determine your eligibility for housing and the types of accommodation that best suit your needs.

Important Information

In British Columbia affordable housing vacancies are limited. To increase your chances of obtaining housing, it is recommended that you apply for several developments and other geographic regions within the province. Visit BC Housing for more information.

Please update this application if any of your information changes by emailing Nelson CARES Society at: housing@nelsoncares.ca

If we do not hear from you annually, your application will be stale dated after twelve months and removed from our active files. To protect private information, we shred all inactive applications.

If you wish to remain on our wait list, please re-submit an application annually.

To increase our ability to reach you, please provide a daytime phone number, phone number of a contact person, or email address. We only contact applicants being considered for a vacant unit.

You will receive a letter of confirmation within 30 days of submitting your application. Please DO NOT call our office to confirm that we have received your application. If you do not receive a letter of confirmation, please contact the office housing@nelsoncares.ca

Please keep this page for your reference. Do not include this page in fax transmissions nor submit it with your application.

(PLEASE PRINT OR TYPE CLEARLY)

For assistance in completing this form, please contact 250-352-6011 ex: 5261

A. Applicant: Person seeking accommodation

Name*
Prefix First Last

Former Name(s):
First Last

Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Work Phone

Message Phone

Email*

B. Household Composition: List yourself on line 1 and then all other persons in your household who will be living with you.

*
Full Name (Last name, first name, initial) Birth Date d/mo/yr Age Gender Relationship to Applicant Type of Disability (if any) Wheel Chair Requirements

Click on the + button on the far right to add rows

Do you expect the number of people in your family to change in the next 12 months? (pregnancy, family joining, family leaving) If yes, please explain:

C. Residency History: List all addresses for the past 5 years. Use a separate sheet if required. Be sure to include the name and phone number of each landlord.

*
Address From Date To Date Name of Landlord Landlord Phone No.

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Have you previously lived in subsidized accommodation or been a tenant of Nelson CARES Society or its predecessor, Nelson & District Housing Society?

*
Yes
No

If yes, please list the property name and location:

What were the dates of your tenancy?

To:

From:

D. Income Information: List gross monthly income [before deductions] for all members of your household, age 19 and older, from all sources. *Note: Effective April 1, 2018, Child support payments are not included as income.

Note: proof of income is required prior to start of tenancy.

*
Name Source (i.e. employment, EI, pension, BC Benefits, etc. Gross Monthy Income ($) Total Gross Monthly Income for Household $

Click on the + button on the far left to add rows

E. Assets: (list the current value of all assets held by you and members of your household)

Note: verification is required prior to start of tenancy.

Cash/Bank Balance $ Stocks/Bonds/ Term Deposits $ Value of Real Estate Owned $

Other assets: Include RRSPs, Annuities, GICs and other investments held by members of your household.

$ $

F. Current Accommodation: Describe your current accommodation as completely as possible:

Your current monthly rent is?

Does your rent include heat?*

If no, how much do you pay for utilities:

Describe your current accommodation:
1. Apartment
2. House/Duplex/Townhouse
3. Housekeeping Room
4. Basement Suite
5. Room & Board
6. Trailer
7. Living with Family/Friends
8. Hotel/Motel
9. Other (please explain)

How many bedrooms to you have now?

Do you:
1. Rent
2. Own
3. Share Expenses
4. Have Free Accommodation
5. Live in a Co-op

Does your present accommodation have a: Bathroom
Private
Shared
None

Does your present accommodation have a: Kitchen
Private
Shared
None

Does your present accommodation have an: Outdoor play area
Yes
No

Do you have any household pets?*
Yes
No

Number of pets?

Type of pet: (Please indicate)

NOTE:Nelson CARES Society Affordable Housing units do not allow pets, Cedar Groves Estates, Copper Mountain Court and Lakeside Place have a strict no pet policy. Ward Street Place has some units that do allow cats, small caged birds, small caged rodents and small aquariums. All pets must be declared, approved, and recorded on tenancy.

Are you willing to give up a pet?
Yes
No

G. REFERENCES: Please give at least 2 references that are not family members or personal friends, (employer, previous landlords, social worker, etc.) and contact information, email, phone number(s), address.

*
Name Relationship Contact Information

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H. Reason for Move:

Are you under notice to end your present tenancy?*
Yes
No

If yes, please upload a copy of the Notice to End Tenancy served by your landlord through the upload option below.

File

If you are not under notice, please describe your reasons for wanting to move.

I. Application Checklist:

Before submitting your Application, please ensure that you have:
completed your Application in full;
included at least two references;
enclosed a copy of the 'Notice to End a Residential Tenancy', if applicable; and
signed and dated the Application in the space below.

DECLARATION: Please read and sign this statement:

I/We declare:

This is my application; and

All the information in it is correct and complete to the best of my knowledge and belief.

I/We authorize:

Pursuant to the Freedom of Information and Protection of Privacy Act (the FOI Act), Nelson Affordable Housing to make any inquiries that are necessary to verify the information given in this application; and

Pursuant to the FOI Act, any person, corporation or social agency to release to Nelson Affordable Housing any information pertinent to the assessment of my/our application; and

Nelson Affordable Housing to receive and exchange with credit bureaus and previous landlords any credit or other information to be used in the decision to provide rental accommodation.

I/We understand that:

In accordance with section 33 (c) of the FOI Act, the information on this application may be shared with other affordable housing providers in order to increase opportunities for rent-geared-to-income housing; and
This application does not constitute any agreement on the part of Nelson Affordable Housing to provide rental accommodation; and

It is my/our responsibility to advise Nelson Affordable Housing of any changes to the information given in this application and to provide relevant supporting materials required or requested.

Signature of Applicant*

Signature of Applicant

Date Signed*

Date Signed

PLEASE NOTE: It is a felony to knowingly provide false, inaccurate, or incomplete information.

PLEASE NOTE: you will receive an email confirming that we have received your application for housing.

If you do not receive and email from us, and have checked your junk mail folder as well as your inbox, please contact the office at 250-352-6011

The information contained within this form is being done so on a web site that is hosted outside of Canada. Nelson CARES Society is unable to confirm the security of this data and/or if this information is stored on this site and therefore outside the care, custody and control of Nelson CARES Society. Informed consent will be considered to have been given through the action of pressing the submit button. Should you not wish to submit this information electronically you are welcome to send this form via Canada Post or drop it by our office .