Fillable SUBSIDIZED HOUSING APPLICATION CHECKLIST (Calgary Housing Company)

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SUBSIDIZED HOUSING APPLICATION CHECKLIST (Calgary Housing Company)

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West District Offi ce
1701 Centre Street NW
Calgary AB T2E 8A4
South District Offi ce
Bay 18, 6624 Centre Street SE
Calgary, AB T2H 0C6
East District Offi ce
Marlborough Mall Prof. Building
320, 433 Marlborough Way NE
Calgary, AB T2A 5H5
587.390.1200
SUBSIDIZED HOUSING APPLICATION CHECKLIST
• All areas of the attached application must be completed.
• Please answer all questions, yes or no in the box beside the question.
• Calgary Housing will NOT accept any application without the documents listed below.
INSTRUCTIONS
FAMILY
FAMILY NUMBERS
INCOME
Landed Immigrant
Pregnancy
Change in Household numbers
– LONG LANDING PAPERS : A Permanent Resident Card is acceptable provided it has the
immigration category on the card
If you arrived in Canada after 2008 then provide a copy of your landing papers for each
Member of the family. The papers will say either Confirmation of Immigration or
Confi rmation of Permanent Residence on the top. “ Verifi cation of Landing” papers is not acceptable.
– A note confi rming pregnancy from a Dr. or an agency advocate stating the due date for each member of the
household who is pregnant
– If you expect members of your family to increase within the next twelve months,
provide confi rmation of their arrival. (This may be a plane ticket or copy of a travel
itinerary.)
Working income
– Each person over the age of 15 years must show pay receipts (stubs) with the last month’s
gross earnings, or provide a letter on company letterhead from their employer stating the
number of average hours worked per week and their hourly monthly income.
If you have stopped working in the past 4 weeks please provide a “Record of Employment”
Self employed business owner
–
(including taxi drivers) Copies of three month’s sales and expenses.
Employment Insurance
–
One current pay receipt / cheque (stubs) or the confi rmation of gross weekly amount
(My Current Claim)
Worker’s Compensation
–
One complete month of gross pay receipts/cheque (stubs).
Social Assistance /Income Support
–
A copy of the 3-part medical services card with names, address and
budget amount.
AISH
–
A copy of the 3-part AISH medical services card with names, address and budget amount.
Child/Spousal Support
–
Include proof of support (letter from your spouse or a copy of the court order.)
Adult Health Benefi t
–
Copy of Approval letter for current year and medical services card
If the following are direct deposited into your bank account, please provide appropriate statement showing
deposit. If not direct deposited, attached the offi cial government payment schedule for each.
-
Old Age Securities - Canada Pension - Alberta Seniors Benefi t
CH404 (2017/12)
ASSETS
SCHOOL
SPECIAL CIRCUMSTANCES
Bank Statement
Property (Including overseas/foreign property)
Vehicles
Student Loans and Grants
Eviction
Emergency/Family Violence
Housing First Graduate
Investments
– Provide a 30-day transaction history for all household bank accounts (including U.S.),
from today, 30 days back including overseas/foreign bank accounts.
– If you or anyone in your household owns property, attach a copy of
the current balance on the mortgage.
If it is to be sold, verify how much money you will receive after
the sale. If the property is foreclosed, submit a letter from your
lawyer or bank as proof, showing either defi ciency judgement or
surplus.
– Attach a copy of any loan or lease papers for all household vehicles, showing current outstanding balance.
– Attach a copy of the School Funding Assessment showing payment for Tuition Fees,
book costs and living allowance.
– Attach a copy of an eviction notice from your landlord, with reason for eviction.
– Attach a letter from an Agency, Shelter or Advocate stating why this is an
emergency situation.
An Emergency Protection order will be accepted in lieu of the above.
– Attach a Letter of Support from Case worker indicating participation in and
acknowledging readiness for graduation from a Housing First Program.
– Attach a copy of all investments except the following: TFSA’s, RESP’s, RRSP’s and RRIF’s.
Frequently Asked Questions regarding
CALGARY HOUSING COMPANY
Q: I have applied for Calgary Housing. What are the next steps?
A:
CHC will process your application and send you a letter advising you of your status on the priority list.
Q: What if there are changes to my situation?
A:
If your address or your phone number change, please call us at 587.390.1200. If there are changes in your family
size, your source or amount of income, the amount of rent that you pay, or the locations where you are willing to live,
please update us in person at any of our three locations or via email at chcapplicant@calgary.ca
Q: What are your offi ce hours?
A:
We are open Monday to Friday from 8:00 a.m. to 4:00 p.m. We are closed on statutory holidays. Our phone lines
are open from 8:00 a.m. to 4:30 p.m. Our phone number is 587.390.1200.
Q: How long will I have to wait for housing?
A:
There is no way to predict how long you will have to wait for housing. There are more than 3,900 people on the
waitlist. Housing is offered based on highest priority. If priority is equal, time on the wait list is the next
consideration.
Q: When will you call me?
A:
We will call you as soon as housing comes available. Please keep your information accurate and up-to-date in
order for us to determine your eligibility.
Q: How often should I check if you have something for me?
A:
In order for your fi le to remain active, you must contact us, either by phone or in person, once per year. Unless
your information has changed there is no reason to contact us more frequently. Frequent contact either in person or on
the phone does not increase your chances of receiving housing. However, if there is a change in your information that
may impact how your priority is determined please update CHC at one of District Offi ces or at
chcapplicant@calgary.ca.
Q: Are there different applications for different programs?
A:
No. One application puts you on the waitlist for all of our programs. The program best suited to your priority will
be offered when you are contacted. If you are interested in a Rent Supplement please ensure you check off this box on
the location update form when applying or updating your location preferences.
We are only able to help those with the highest priority on our waitlist.
There are more than 3,900 families on the waitlist at CHC.
Q: How is my priority determined?
A:
Priority of Need and Allocation of Housing is determined by The Social Housing and Accommodation
Regulations (SHAR). Several factors including but are not limited to: Source and amount of total household income,
amount of rent paid, number of dependants in the household, and current circumstances that effect a living situation
are used to determine priority. Other factors are also considered and can be found on page 14 of SHAR.
www.qp.alberta.ca/documents/Regs/1994_244.pdf
CHC is required to follow these regulations when offering housing solutions to applicants.
Q: How am I able to submit my application?
A:
Applications may be submitted using email to: chcapplicant@calgary.ca or in person or fax at one of our 3 District
Offi ces currently located at:
West District Offi ce
1701 Centre Street NW
Calgary AB T2E 8A4
Fax: 587-390-1201
South District Offi ce
Bay 18, 6624 Centre Street SE
Calgary, AB T2H 0C6
Fax: 587-390-1251
East District Offi ce
Marlborough Mall Prof. Building
320, 433 Marlborough Way NE
Calgary, AB T2A 5H5
Fax: 587-390-1212
Calgary Housing Company
SUBSIDIZED HOUSING APPLICATION
APPLICANT CONTACT INFORMATION
Last Name
Mailing Address
Contact
– Please mark which phone number you would prefer us to use to contact you during working hours. (8:00am – 4:00pm)
Current Housing Information
City Province Postal Code
First Name Maiden Name (if applicable)
Home: ( )
What portion of the current monthly rent does your household pay? $
Do you have help paying your rent? Yes No $ From who
How long have you lived there? Years Months
I pay for:
Cell: ( ) Email:
Water Electricity Heat
Yes Yes YesNo No No
Family Numbers
Yes No
Do you expect the number of people in your family to change in the next 12 months?
If yes, please explain:
If someone in the household is pregnant, please attach confi rmation including the due date from an agency or advocate.
For offi ce use only
Address Book # Lease # Picture ID Checked: Yes No
Family
– List the names and information of all the people who will be living in the unit. Include your name (applicant) with this list.
LAST NAME First Name Birthdate Gender
Relationship
to applicant
Date of arrival
in Canada
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
yy mm dd
//
M
M
M
M
M
M
M
F
F
F
F
F
F
F
U
U
U
U
U
U
U
SELF
* Attach LANDING PAPERS for each member of the household who arrived in Canada after 2005.
( )
( )
INCOME AND ASSETS
Income
List and provide copies of all the income received for each member of the household over 15 years of age.
$
$
$
$
$
$
$
Name
Assets
Name of Employer
or
Source of Income
Total Value
Monthly Amount
(before taxes)
Income or Interest
Received in the last 12 months
List all assets held both within Canada and in other countries as per the list below.
Documents are required for items listed below including mortgage papers, property sale agreements and bank
statements for all monthly income received.
$
$
$
$
$
$
$
$
Chequing/Savings/U.S. and other foreign/
overseas Bank Accounts
Term Deposits, Savings Bonds
(GIC Guaranteed Investment Certifi cate.)
Mutual Funds or Stocks
Property – Full or part ownership in a house, or land.
School
Vehicle
Is anyone over the age of 18 attending school full time?
Are you a Housing First graduate?
Do you
have vehicles?
Vehicle
description
Vehicle
description
Do you have a loan?
Provide current balance for any lease or loan agreements for any of the above vehicle(s)
Outstanding balance: $
Make:
Make:
Model:
Model:
Number of doors:
Number of doors:
Year:
Year:
Do you lease
your vehicles?
When does
your lease end?
If yes, attach a copy of your school funding assessment for each person who is attending school over the age of 18.
Please provide documentation
Yes
Yes
No
No
Yes Yes (yy/mm/dd)No No
Yes No
Previous address:
Previous address:
I live there from: until
I live there from: until
Reason for leaving:
Reason for leaving:
Landlord’s name:
Landlord’s name:
Landlord’s telephone number:
Landlord’s telephone number:
Calgary Housing History
Current Living Situation
Has anyone on this application ever lived in subsidized housing in Calgary?
Have you been asked to leave your current address?
If yes, what is the address of the subsidized unit:
Do you have an eviction notice? (Attach a copy to the application)
When did you move out?
Yes
Yes
Yes
No
No
No
Rental Unit (Apartments, House, Townhouse)
Living with family and friends.
Shelter
Group Home
Rooming house
I currently live in a ..... The place where I am living has...
Number of bedrooms in the unit/home
My family uses (Number of bedrooms used)
Business
History
– List all previous housing information for the past two years.
Do you have ownership in a business?
Previous address:
Name of business:
I live there from: until Reason for leaving:
Address of business:
Landlord’s name: Landlord’s telephone number:
If yes, attach your 3 most recent month’s fi nancial statement.
Yes No
HOUSING
( )
( )
( )
Please tell us why you want to live with Calgary Housing Company?
Name:
Name:
Address:
Address:
Phone: ( )
Phone: ( )
Relationship:
Relationship:
– Contacts may include: Relatives, next of kin, friends who are not
living with you.
Emergency and Other Contacts
Accessibility
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Pets
• Calgary Housing Company has very few units that allow pets; therefore, having a pet
may make your wait for housing longer.
• Calgary Housing Company places that do accept pets have a limit of one per unit
Do you own a pet?
My dog is a service animal:
If yes, please provide documentation.
Do you need wheelchair access?
List the type of pet(s) and the number of each:
Are you able to climb stairs?
I am willing to fi nd a new home for my pet:
Please request an “Accessible Unit Evaluation form” from Customer Service
Support Workers or Counselor (if any)
Name:
Name:
Address:
Address:
Phone: ( )
Phone: ( )
Relationship:
Relationship:
Interpreter or other person we may talk to who is helping you in your housing search
( )
( )
( )
( )
Pursuant to the Freedom of Information and Protection of Privacy Act (“FOIP”), by signing this application
form below, I give the Calgary Housing Company my consent to make inquiries of, and collect personal
information from, other persons, organizations including social and government agencies as necessary to
verify the information on this application. I authorize any person, corporation, or other organization, including
any social or government agency, to release to the Calgary Housing Company any information pertinent to
the Calgary Housing Company’s processing, verifi cation, or assessment of this application. These persons
may include, but are not limited to, landlords, employers, credit bureaus, and social and government
agencies.
This personal information is being collected by the Calgary Housing Company under the authority of Section
33(c) of FOIP. All personal information is collected by the Calgary Housing Company for the purpose of
determining eligibility for Calgary Housing Company and related housing programs, carrying out Calgary
Housing Company programs, activities or policies, and ensuring a safe and secure environment for all
our clients. I understand that the Calgary Housing Company may also disclose information as authorized
by FOIP to the Federal Government, the Provincial Government, or the City of Calgary for the purpose of
carrying out programs, activities or policies regarding affordable housing strategies under their administration
(e.g. research and evaluation) or to help the Calgary Housing Company receive provincial and/or federal
funding. By signing this application form below, I consent to, and authorize the Calgary Housing Company to
use and disclose my personal information as described in this paragraph.
Signature of Applicant (over 18):
Signature of Applicant (over 18):
Signature of Applicant (over 18):
Signature of Applicant (over 18):
Date:
Date:
Date:
Date:
Statutory Declaration: I/We _______________________________ of the City of Calgary in the Province of
Alberta, so solemnly declare as follows:
1) That I am the applicant(s).
2) That the statements made by me in the said declaration(s) are, to the best of my knowledge, information and
belief, full and true in all respects: And I/we make this solemn declaration conscientiously believing it to be true
and knowing that it is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.
Declared before me
In the Province of Alberta at the City of Calgary
This day of , 20 .
Signature of applicant:
Signature of applicant:
FOR OFFICE USE ONLY
CALGARY HOUSING COMPANY
LOCATION UPDATE FORM
Housing Locations
South East
South West
North East
North West
Central
Requesting Rent Supplement
* Please note: Calgary Housing has bachelor and one bedroom units for singles.
Select the areas below where you are willing to live.
Anywhere in
the South East
Anywhere in the
South West
Anywhere in the
North East
Anywhere in the
North West
Applewood
Penbrooke
Forest Lawn /
Forest Heights
Dover
Strathcona
Rosscarrock
Shaganappi
Manchester
Ranchlands
Dalhousie
Edgemont
MacEwan
Beltline
Castleridge
Falconridge
Whitehorn
Killarney
Glenbrook
Lincoln Park
South Calgary
Beddington
Thorncliffe
Huntington
North Haven
Downtown
Temple
Rundle
Pineridge
Mission
Oakridge
Cedarbrae
Parkhill
Capital Hill
Highland Park
Hillhurst
Kensington
Abbeydale
Mountain View
Vista Heights
Woodbine
Woodlands
Millrise
Shawnessy
Montgomery
Bowness
Varsity
Crescent Heights
Renfrew
Bridgeland
Erinwoods
Radisson
Southview
West Dover
Inglewood
Ramsay
Ogden
Willow Park
Midnapore
Deer Valley
McKenzie
Parkland
As there is a high need for affordable housing, I understand and agree that if I refuse a unit
from one of the areas I selected above, Calgary Housing Company will suspend my fi le and will not
offer me another unit for 6 months.
Applicant Signature
Date
Address book #
Email address
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Completed 30 June 2021

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