MARKET RENT APPLICATION by dangerrous

VIEWS: 4 PAGES: 5

									                         KITCHENER HOUSING INC.
                 11 Weber Street West, Kitchener, Ontario N2H 3Y9

                        MARKET RENT APPLICATION

DATE: _________________             Is an Interpreter Needed: Yes   No
      Month Day Year                                     Language _______________

APPLICANT #1


First Name                             Last Name                  Date of Birth
                                                                Month Day Year

Social Insurance Number                Gender Male          Marital Status
                                             Female
Street Number    Street Name               Apt/Unit #    City         Postal Code


Home Phone #                                Alternate Contact Person
                                            Name                     Telephone #
Work Phone #
Can you take calls at work? Yes   No        ______________________ __________
                                            Friend      Relative
                                            Interpreter    Other

APPLICANT #2


First Name                             Last Name                  Date of Birth
                                                                Month Day Year

Social Insurance Number                Gender Male          Marital Status
                                             Female
Street Number    Street Name               Apt/Unit #    City         Postal Code


Home Phone #                                Alternate Contact Person
                                            Name                     Telephone #
Work Phone #
Can you take calls at work? Yes   No        ______________________ __________
                                            Friend      Relative
                                            Interpreter    Other
OTHER PEOPLE LIVING IN THE HOME

      Last Name                 First Name           Age         Relationship




Is a Baby Expected? Yes       No       If Yes, when? _____________________________


Pets Please list all pets to live with you (Breed) _________________________________



INCOME

Source of Income ________________________________________________________

Present Employer

_______________________________________________________________________
Name                              Address                        Phone

How long have you worked at your present employment? _________________________

Monthly Income $_________________________

Previous Employers

1)______________________________________________________________________

2)______________________________________________________________________

3)______________________________________________________________________



OTHER HOUSING NEEDS/SPECIAL FEATURES

Accessibility: Wheelchair     Visual     Hearing   Other (describe) _____________

Do you require parking? Yes     No         Number of parking spots needed______
PRESENT LANDLORD

Do you own your own home?         Rent
Present Landlord’s Name           Address                       Phone #


How long have you lived at your current address? _____________________________
                                                _____________________________
Are you under Notice to Vacate? Yes     No

If “yes”, please explain and attach notice to vacate

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

PREVIOUS ADDRESSES

Previous Addresses                        Dates          Landlords Name & Phone #
                                               To
                                               To
                                               To
                                               To



HOUSING SELECTION

What type of housing do you want?            How much rent do you want to pay?
Apartment                                    $ ___________ per month
Townhouse
Does not matter


Please list the developments where you want to live (see KHI Property List attached)
1)________________________________ 4)______________________________
2)________________________________ 5)______________________________
3)________________________________ 6)______________________________
PERSONAL REFERENCES/phone numbers (No family members)

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________


                         TENANT VEHICLE INFORMATION

If your household owns two (or more vehicles), all information must be listed on this form.
                                            1                                               2
VEHICLE(S):YEAR: ________________                     _____________________

               MAKE: _________________                 ___________________

               MODEL: ________________                 ___________________

               COLOUR: _______________                ___________________

               LICENCE NO. _______________                  ________________

1. It is understood that one (1) vehicle per unit is permitted parking on the premises . A
second vehicle will be permitted if space allows at a charge of $20 above ground/$25
underground per month.

2. The vehicle must be roadworthy and have current license plates on it at all times.

3. The vehicle must be owned by the current tenants and be used for personal use only.

4. Parking of commercial vehicles, recreational vehicles, trailers, boats, etc. is not allowed
    on the premises.

5. Vehicles must not be repaired on-site.

6. Kitchener Housing Inc. must be notified of any change to the above information.

   Tenants will be required to pay for all damages to roadways, driveways and common
   parking lots caused by leaking vehicles owned and operated by the tenant and guests.

Vehicles that do not conform will be ticketed or towed away at the Owner’s expense.

Date __________________

Owner:________________               Owner 2nd vehicle______________________
DECLARATION

The following statements are true.

   1. The information I have given on this form is true.
   2. I understand if I enter into a lease agreement with KHI, only the people on this
      form can live with me.
   3. I understand I must report any changes in the number of people who live with me.
   4. I understand I must report all new pets (breed & description) to KHI.
   5. I understand I must report all vehicles to KHI

CONSENT TO OBTAIN PERSONAL INFORMATION

I/We authorize and agree that Kitchener Housing Inc. may collect, use and disclose the
personal information that I/We have provided in this form. I/We understand and
acknowledge that, in addition to the foregoing, Kitchener Housing Inc. will also collect,
use and disclose my/our personal information as required or permitted by law.

_________________________________                _________________________________
Applicant’s Signature                            Applicant’s Signature

_________________________________
Date

								
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