Application for Housing

Application for Accommodation to Pleasant View Apartments 7540 Hurd St. Mission BC

An independent living – subsidy through BC Housing rent based on 30% of income and approved by BC Housing (base rate of $320 if on government support)

**Application for Park Side Apartments at 7530 Hurd St. Mission BC

Self-contained with furniture, dishes and linens. “Micro” accommodations but has private front door. Rent $650.00 per month includes one hot meal every evening and light housekeeping and fresh linens weekly

**Application for Loft Apartments at Pleasant View 7530 Hurd St. Mission, BC

Rate ranges all different sizes: $745 – 1 bed; $725 – 1 bed; $740 1 bed; $675 – 1 bed & patio; $565 – bach & patio; $550 bach & patio; and, $ 665.00 – 1 bed. light housekeeping bi weekly with utilities included

**These 2 types of accommodations do not fall under the Residential Tenancy Act and all rents are subject to change.

All units are non-smoking

Preferred Locations if applying for more than one of our of our independent housing options:

Please indicate the accommodation applied for – you can apply for all three if you wish by ranking accordingly.
Note:“1” , “2” or “3”, with “1” being your first choice – place a “n/a” if no interest in any one of the accommodations listed.

Pleasant View Apartments (for over 60 years of age only) *

Application for Park Side Apartments *

Application for Loft Apartments at Pleasant View *

Be sure to complete all questions on the application. Items marked with an * are required.

Applicant

(Person applying asking for accommodation)

Last Name *

First Name *

Honorific *

Mr.Mrs.MissMs.

Birth Date *

Age *

Sex *

Type of Disability if applicable *

Wheelchair/walker access required *

YesNo

Total number of persons seeking to live in the unit *

Current Address *

Apartment, suite, etc

City *

Province *

Postal Code *

Country

Email Address *

Phone *

Phone number where a message can be left

Alternative contact

Please list the name and number of an alternative contact if needed.

Name

Phone

Please note in order to keep your application current we must be notified of changes in contact information.

Others seeking to move in with you:

Name

Birth Date

Age

Sex

Relationship to Applicant

Type of Disability if applicable

Wheelchair Requirements

YesNo

Do you expect the number of people in your family to change in the next 12 months? *

YesNo

If yes, please explain

Is there someone else we should contact to discuss your application and who will speak on your behalf? *

YesNo

If yes, Name

Relationship

Phone

Residency History

(Please list your address(es) for the past 2 years.)

Address *

From *

Name of Landlord *

Landlord's Phone *

Permission to contact *

YesNo

Address

From

Name of Landlord

Landlord's Phone

Permission to contact

YesNo

Address

From

Name of Landlord

Landlord's Phone

Permission to contact

YesNo

Please list at least two people as references if not noted above that we may contact who can speak to your tenancy behaviours.

Name *

Relationship *

Phone *

Email Address *

Length of time applicant has known this reference *

Name *

Relationship *

Phone *

Email Address *

Length of time applicant has known this reference *

Have you previously lived in subsidized accommodation?

YesNo

If yes, what was the name and/or address of the development?

What do you currently pay for rent? *

What does your rent include? *

What were the dates of your residency?

From

To *

Reason for leaving *

Have you ever been evicted? *

YesNo

If yes, please list date(s) of eviction(s) and reason why you were evicted

Income Information

(List gross monthly income [before deductions] for all members of your household, age 19 and  older, from all sources.) Record of Income will be required.

First Name (Person 1) *

Income Source *(i.e. employment, EI, pensions, CPP, PWD, BC Benefits, SAFER etc.)

Gross Monthly Income *

First Name (Person 2)

Income Source(i.e. employment, EI, pensions, CPP, PWD, BC Benefits, SAFER etc.)

Gross Monthly Income

First Name (Person 3)

Income Source(i.e. employment, EI, pensions, CPP, PWD, BC Benefits, SAFER etc.)

Gross Monthly Income

First Name (Person 4)

Income Source(i.e. employment, EI, pensions, CPP, PWD, BC Benefits, SAFER etc.)

Gross Monthly Income

Total Gross Monthly Income for Household (Add together the amounts from above) *

Assets

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

Cash/ Bank Balance *

Stocks/Bonds/ Term Deposits *( If not applicable, please enter n/a)

Value of  Real Estate Owned *( If not applicable, please enter n/a)

Other assets:

(e.g. RIFs, RRSPs, Annuities, Mortgages held by household members) Please list below. If not applicable, please enter n/a

( If not applicable, please enter n/a)

Please note you may be asked for proof of income and assets when your application is reviewed for acceptance.

Current Situation

Please state: Your current monthly rent *

What do you believe to be your affordable maximum monthly rent amount? *

If you selected Other, please explain

Are you currently struggling with an infestation of bed bugs? *

YesNo

Comments

If no, have you ever been bothered by bed bugs? *

YesNo

Date and location

Do you smoke (tobacco/cannabis)? *

YesNo

If you smoke, will you agree not to smoke in your apartment or anywhere on the property? *

YesNo

Do you have any household pets? (dog(s), cat(s), birds, fish etc.) *

YesNo

If yes, what type

If you have a pet, are you willing to arrange alternative living arrangements for your pet? *

YesNo

Reason for Move

Are you under notice to end your present tenancy? *

YesNo

If yes, date you must move is

If yes, please attach a copy of the legal Notice to End a Residential Tenancy from your landlord if available.

No file chosen

Why do you wish to move? (Please be specific) *0 / 300

Has someone else completed this application form for you? *

YesNo

If yes, who completed this form

Relationship

Application Checklist

Before returning your Application for Accommodation have you:

Completed your Application in full? (Make sure all required fields are filled. If not applicable enter n/a)

Yes

Indicated your preferred housing locations? *

Yes

Enclosed a copy of the ‘Notice to End a Residential Tenancy’, if applicable?

Yes

Declaration & Authorization

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), Pleasant View Housing Society has permission 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 Pleasant View Housing Society any information pertinent to the assessment of my/our application; and
That Pleasant View housing Society can receive and exchange with credit bureaus and my/our previous landlords credit and other information about me/us, to be used in the decision making process to provide me/us with 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 my/our opportunities for rent-geared-to-income housing; and
That this application does not constitute any agreement on the part of Pleasant View housing Society to provide me/us with rental accommodation; and it is my/our responsibility to advise Pleasant View Housing Society of any changes to the information given in this application and to provide any supporting materials required for my/our application.

I have read and agree to the above statements *

All information is correct & complete to the best of my knowledge & belief.

Date of Application *

Application for Housing

Application for Accommodation to Pleasant View Apartments 7540 Hurd St. Mission BC

**Application for Park Side Apartments at 7530 Hurd St. Mission BC

**Application for Loft Apartments at Pleasant View 7530 Hurd St. Mission, BC

Applicant

(Person applying asking for accommodation)

Honorific *

Wheelchair/walker access required *

Wheelchair Requirements

Do you expect the number of people in your family to change in the next 12 months? *

Is there someone else we should contact to discuss your application and who will speak on your behalf? *

Residency History

(Please list your address(es) for the past 2 years.)

Permission to contact *

Permission to contact

Permission to contact

Please list at least two people as references if not noted above that we may contact who can speak to your tenancy behaviours.

Have you previously lived in subsidized accommodation?

Have you ever been evicted? *

Income Information

(List gross monthly income [before deductions] for all members of your household, age 19 and older, from all sources.) Record of Income will be required.

Assets

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

Current Situation

Heat? *

Electricity? *

Cable? *

Describe your current accommodation: *

Are you currently struggling with an infestation of bed bugs? *

If no, have you ever been bothered by bed bugs? *

Do you: *

Do you smoke (tobacco/cannabis)? *

If you smoke, will you agree not to smoke in your apartment or anywhere on the property? *

a Bathroom:

a Kitchen:

Do you have any household pets? (dog(s), cat(s), birds, fish etc.) *

If you have a pet, are you willing to arrange alternative living arrangements for your pet? *

Reason for Move

Are you under notice to end your present tenancy? *

Has someone else completed this application form for you? *

Application Checklist

Before returning your Application for Accommodation have you:

Completed your Application in full? (Make sure all required fields are filled. If not applicable enter n/a)

Indicated your preferred housing locations? *

Enclosed a copy of the ‘Notice to End a Residential Tenancy’, if applicable?

I have read and agree to the above statements *

(List gross monthly income [before deductions] for all members of your household, age 19 and  older, from all sources.) Record of Income will be required.