Fillable APPLICANT UPDATE FORM (Lu'ma Native Housing Society)

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APPLICANT UPDATE FORM (Lu'ma Native Housing Society)

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Country of origin: CANADA
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LU’MA NATIVE HOUSING SOCIETY
2960 NANAIMO STREET, VANCOUVER, BC V5N 5G3
Website: www.lnhs.ca Email: info@lnhs.ca
Phone: (604) 876-0811 | Fax: (604) 876-0999
APPLICANT UPDATE FORM
***PLEASE EMAIL, FAX, OR MAIL YOUR APPLICANT UPDATE FORM***
NOTE: To keep your file active, please report any changes in Household composition, income sources, address
or phone number changes. If mailing or faxing forms,
PLEASE PRINT CLEARLY.
THIS FORM IS ONLY TO BE USED IF YOU ARE ON THE WAITLIST.
FILE #: __________ DATE: _____________
Full Name:
Cell:
Address:
Suite:
Home:
City:
Prov:
Postal:
Work:
Email:
Msg:
TYPE OF HOUSING
I am in need of ☐ Subsidized Rent ☐ Market Rent
HOUSEHOLD COMPOSITION
Full Name:
Birthdate
(DD/MM/YY)
Relationship to Applicant
APPLICANT
APPLICANT
Do you expect your family size to change within the next 12 months? ☐ Yes ☐ No
Reason: ___________________________________________________________________________________
First Nations, Metis, and Inuit
Nation/Community
2 | P a g e
INCOME INFORMATION
List GROSS (before taxes) monthly income for members over 19 from all income sources.
Name
Source (Employment, EI, Social Assistance, etc.)
Amount
Total Monthly Gross Income
HOUSING INFORMATION
Do you or a member of your household require accessible or have restrictive mobility? ☐ Yes ☐ No
Name
Accessible
Provide Details:
(e.g. wheelchair accommodation, home support services,
limitations doing stairs)
☐
☐
COMMENTS (on current situation)
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APPLICANT UPDATE FORM (Lu'ma Native Housing Society)

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Completed 11 March 2021

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