For Market Rent Units APPLICATION SUBMISSIONS - CHF BC
Application for Tenancy 80 and 122 Walter Hardwick Avenue, Vancouver
For Market Rent Units Phone Inquiries: 604-787-6348
Email Inquiries: [email protected]
APPLICATION SUBMISSIONS PLEASE INCLUDE THIS PAGE AS A COVER PAGE FOR ANY SUBMISSIONS E mail Submissions: [email protected] Fax Submissions: 604-879-8792 Mail Submissions: 202-5550 Fraser Street, Vancouver BC, V5W 2Z4 We do not accept applications in person Please do not submit further documents once we have received your application, unless requested by COHO
Name: ____________________________________ Submission Date: _______________________ Surname
Given Name
DD/MM/YYYY
Total Number of Pages (Including Cover Page): __________________ Application #: _________________ Candidate Profile (check off all that apply*):
I live in Vancouver I work in Vancouver I volunteer in Vancouver I work in essential services (Public education, public healthcare, police, or fire services) I am a senior or person with disabilities I am currently registered with BC Housing (File Number: _____________________) *Supporting documents and information must be included in the body of the application.
Additional Information (check off):
I understand that if selected it is my responsibility to arrange an account with Enerpro & BC Hydro and have a commitment to minimize my carbon footprint in my community.
I am willing to be interviewed and am able to demonstrate my interest in community stewardship
I understand that if I am shortlisted for a unit I will be contacted by COHO and that this is only an application with no guarantee of units. ______________________________________ Signature
FOR COHO OFFICE USE ONLY:
Date received & Delivery method: ________________________________ Interview Recommended: _______________________________________
Application for Tenancy 80 and 122 Walter Hardwick Avenue, Vancouver
For Market Rent Units Who is Eligible The following individuals are eligible for tenancy at 80 and 122 Walter Hardwick Avenue, Vancouver: Canadian citizens not under sponsorship individuals lawfully admitted into Canada for permanent residence and not under sponsorship refugees sponsored by the Government of Canada individuals who have applied for refugee or immigration status
individuals for whom sponsorship has broken down.
Priority will be given to: emergency service, public health or public education workers who work in Vancouver people who currently live or work or volunteer in Vancouver. Applicants‟ monthly gross household income from all sources must not exceed five times the market rent: Unit Size One bedroom Two bedroom Three bedroom Four bedroom
Market Rent $1,501 $1,902 $2,096 $2,368
Maximum Monthly Income $9,000 $11,412 $12,576 $14,206
Applicants are required to submit proof of income with this application. Purpose of this Form This application form is designed to collect specific information from applicants seeking housing at 80 and 122 Walter Hardwick Avenue, Vancouver in accordance with the Personal Information Protection Act (PIPA) and the Freedom of Information and Protection of Privacy Act (FOIPPA) to the extent applicable. COHO uses this information to determine your eligibility for housing and the types of accommodation that best suit your needs. The information collected will only be used in accordance with the referenced legislation. Security Deposit Tenants are required to pay a security deposit equal to one-half of one month's rent as a term of the tenancy agreement. Assignment and Subletting Assignment of tenancy agreements and subletting of rental units is not permitted. Pet Policy Tenants are allowed one cat or one dog (with breed restrictions) per one-bedroom unit and up to a total of two cats or two dogs or one dog and one cat in two-bedroom and larger units. Other permissions and restrictions apply as per the Pet Policy. Tenants with approved pets are required to pay a pet deposit equal to one-half of one month's rent. COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 1 of 9
Smoke-free Housing Certain floors in both buildings are designated as non-smoking floors. Smoking is also prohibited in all common areas and on balconies and patios. The smoking policy applies to tenants and guests. Important Information COHO will not process incomplete applications. Applicants who fail to provide required information to COHO or who provide false or misleading income and occupancy verification information are ineligible for housing. Please update your application if any of your information changes. COHO reviews all applications received and will contact approved applicants to invite them to an interview as soon as a vacancy occurs. If you have any questions about completing this form, contact COHO by email at [email protected] or by telephone at 604-787-6348.
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 2 of 9
APPLICATION FOR TENANCY 80 Walter Hardwick Avenue, Vancouver 122 Walter Hardwick Avenue, Vancouver
Please answer all questions and type or print clearly. If you need extra room for any question, attach another sheet to the application. Return completed form to COHO Property Management by: Email: [email protected]
Fax: 604-879-8792
Mail: 205-5550 Fraser St, Vancouver, BC, V5W 2Z4
1. Applicant Information Person(s) asking for accommodation Last name
First name
Mr.
Home phone
Work phone
Message phone
Last name
First name
Home phone
Work phone
Message phone
Mr.
Ms.
Ms.
Mrs.
Miss
Mrs.
Miss
Home address: suite, house number, street, city, province, postal code Mailing address (if different from above):
2. Household Information 2a. List yourself, then all other household members. If required, attach separate sheet for more names. Last Name
Relationship to Applicant
First Name
Birth Date dd/mm/yyyy
Age
Sex
Born in Canada?
Yes
No
2
Yes
No
3
Yes
No
4
Yes
No
5
Yes
No
6
Yes
No
7
Yes
No
1
Self
2b. Do you expect the number of people living with you to change in the next 12 months? (e.g., pregnancy, family joining, family leaving, child in care)
Yes
No
If Yes, please explain:
2c. For each person not born in Canada, please provide the information below. COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 3 of 9
Name
Date Moved to Canada
Current Status in Canada
2d. Do all of the people listed live with you full time right now? Yes No If No, please provide the name(s) of the person(s) and number of days per week they live with you. Name
# days per week
Shared custody?
Yes
No
Yes
No
Yes
No
If not shared custody, why are they not living with you full time?
2e. Do you or any member of your household work for the City of Vancouver Police Department or Fire Department, or work for the BC Ambulance Service, in public health or in public education in the City of Vancouver?
Yes
Name
No If yes, complete the following table. Employer
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Job Title/Occupation
Page 4 of 9
3. Income Information List gross monthly income (before deductions) for all members of your household, age 19 and older, from all sources including employment, EI, pensions, income assistance, child/spousal support, etc. Do not include income of dependent children under the age of 25 attending school full-time. First Name
Source of Income
Gross Monthly Income ($)
1 2 3 4 5 6 7 Total Gross Monthly Income for Household
$
4. Health and Mobility Information To assist with matching you to housing that best suits your needs, please complete the following questions. If no member of your household has a health condition or disability, go to Section 5. 4a. Do you or any members of your household have restrictions with stairs?
No restrictions
Cannot manage stairs
Limited number of stairs (How many? _________)
4b. Do you or any members of your household use a: Wheelchair?
Yes
No
Scooter?
Yes
No
If Yes, who? __________________________________________________ If a wheelchair/scooter is used, is it used inside your home? If Yes, is it used in the kitchen?
Yes
No
Yes
No
If Yes, is it used in the bathroom?
Yes
No
4c. Other than mobility concerns, do you or any members of your household have a health condition or disability that affects your housing needs? Name
Yes
No
If Yes, please explain:
Explain the health condition or disability and describe how it affects your housing needs
4d. Please describe any special requirements or features that you may need in your housing related to mobility or any health condition.
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 5 of 9
5. Housing Preferences/Choices 5a. Accommodation size you are looking for Check one
Initial Monthly Market Rent
One
$1,601
Two
$1,902
Three
$2,096
Four
$2,368
# of Bedrooms
5b. I/we confirm that I/we are able to pay the monthly market rent listed above.
Yes
No
5c. Date for which you are looking for accommodation/are able to move in: ________________________ 5d. Do any members of your household smoke and/or require accommodation where smoking is permitted?
Yes
No
5e. There are a very limited number of parking spaces available at 80 and 122 Walter Hardwick Avenue. Parking is not included in rent and costs an additional $75 per space per month. How many vehicles do you require parking for? ________ Would you consider housing without parking?
Yes
No
5f. Do you have any pets? If Yes, how many pets in total? _______________ Provide the following information for all household pets. Type
How many
Details Breed(s):
Dog Cat Describe: Other
6. Residency History Please list your last three addresses. Address
From Date (dd/mm/yyyy)
COHO - Application for Tenancy – Market (Rev. Jan 2011)
To Date (dd/mm/yyyy)
Name of Landlord
Landlord Phone No.
Page 6 of 9
7. Commitment to Sustainability Sustainability was a priority in the design and building of 80 and 122 Walter Hardwick Avenue. For example, the buildings reuse rainwater for toilet flushing and landscape irrigation. Bathrooms and kitchens are equipped with high efficiency appliances. Large portions of the roof and courtyard areas are covered with green roofs. Composting centres will also help residents to reduce their carbon emissions. Rainwater from public spaces is collected and treated in a storm water wetland before release to False Creek. The buildings are connected to the Neighbourhood Energy Utility, a district heating system that uses sewer heat recovery for space heating and domestic hot water. Solar energy and tripleglazed windows will further reduce energy consumption. All units have in-suite energy consumption monitors so owners can regulate their energy consumption. Tenants will be required to pay a security deposit of $20 for their energy monitor. I/we are committed to helping achieve the sustainability goals at 80 and 122 Walter Hardwick Avenue.
Yes
No
8. Application Checklist: Before returning your Application for Accommodation, have you:
Completed your Application in full? Enclosed the following documents, if applicable: Proof of Canadian citizenship or immigration status for all household members If you neither live nor work in Vancouver, a letter from the organization you volunteer with, if applicable, confirming your status as a volunteer Proof of income from all sources (Notice of Assessment for previous year; if employed, last three consecutive pay stubs or letter from employer; if self-employed, copy of Statement of Business Activities and Income Tax Return) Copies of cheque stubs, bank statements showing direct deposit of pensions, or other confirmation of income for any other income source Proof of student status for household members age 19 to 24 who attend school full-time Copy of the „Notice to End a Residential Tenancy‟, if applicable
Signed and dated the Application in the shaded space below? Completed Schedule “A”, attached?
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 7 of 9
DECLARATION: Please read and sign this statement. The applicant(s) and all adult household members (anyone 19 and older) must agree to the following:
I/We declare: This is my application and/or verification form; and All the information in it is correct and complete to the best of my knowledge and belief. I/We authorize: Pursuant to the Personal Information Protection Act (PIPA) and the Freedom of Information and Protection of Privacy Act (FOIPPA) to the extent applicable, COHO Property Management (COHO) to make any inquiries that are necessary to verify the information given in this application; and Pursuant to PIPA and FOIPPA to the extent applicable, any person, corporation or social agency to release to COHO any information pertinent to the assessment of my/our application; and COHO to 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 this application does not constitute any agreement on the part of COHO to provide me/us with rental accommodation; and That it is my/our responsibility to advise COHO of any changes to the information given in this application and to provide any supporting materials required for my/our application; That the provision of false or misleading information is grounds for ending tenancy; and That if it is necessary in order for COHO to perform a credit check, I/we will be required to provide my/our Social Insurance Number(s) in order for my/our tenancy to be considered. Signature of Applicant
Date
Signature of Applicant
Date
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 8 of 9
SCHEDULE “A” COHO CREDIT REPORTING SERVICE To allow COHO to obtain a credit report, please complete the following information. Type or print clearly and include your postal code(s). Only complete the information for the Co-Applicant if a credit check is being done for them; otherwise leave it blank. This form is for information only, and a credit check cannot be completed without the signed Declaration on page 7 of the Application for Tenancy (must also be signed by the Co-Applicant if applicable). Credit checks will be performed only for applicants whose tenancy is under consideration following an interview.
APPLICANT First Name
Middle Name(s)
Mr.
City
Province
Postal Code
# of years
Last Name
First Name
Middle Name(s)
Mr.
Province
Postal Code
# of years
Last Name
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Current Address
Previous Address City Date of Birth (YYYY-MM-DD)
Social Insurance Number (optional)
CO-APPLICANT First Name
Middle Name(s)
Mr.
City
Province
Postal Code
# of years
Last Name
First Name
Middle Name(s)
Mr.
Province
Postal Code
# of years
Last Name Current Address
Previous Address City Date of Birth (YYYY-MM-DD)
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Social Insurance Number (optional)
Page 9 of 9
For Market Rent Units Phone Inquiries: 604-787-6348
Email Inquiries: [email protected]
APPLICATION SUBMISSIONS PLEASE INCLUDE THIS PAGE AS A COVER PAGE FOR ANY SUBMISSIONS E mail Submissions: [email protected] Fax Submissions: 604-879-8792 Mail Submissions: 202-5550 Fraser Street, Vancouver BC, V5W 2Z4 We do not accept applications in person Please do not submit further documents once we have received your application, unless requested by COHO
Name: ____________________________________ Submission Date: _______________________ Surname
Given Name
DD/MM/YYYY
Total Number of Pages (Including Cover Page): __________________ Application #: _________________ Candidate Profile (check off all that apply*):
I live in Vancouver I work in Vancouver I volunteer in Vancouver I work in essential services (Public education, public healthcare, police, or fire services) I am a senior or person with disabilities I am currently registered with BC Housing (File Number: _____________________) *Supporting documents and information must be included in the body of the application.
Additional Information (check off):
I understand that if selected it is my responsibility to arrange an account with Enerpro & BC Hydro and have a commitment to minimize my carbon footprint in my community.
I am willing to be interviewed and am able to demonstrate my interest in community stewardship
I understand that if I am shortlisted for a unit I will be contacted by COHO and that this is only an application with no guarantee of units. ______________________________________ Signature
FOR COHO OFFICE USE ONLY:
Date received & Delivery method: ________________________________ Interview Recommended: _______________________________________
Application for Tenancy 80 and 122 Walter Hardwick Avenue, Vancouver
For Market Rent Units Who is Eligible The following individuals are eligible for tenancy at 80 and 122 Walter Hardwick Avenue, Vancouver: Canadian citizens not under sponsorship individuals lawfully admitted into Canada for permanent residence and not under sponsorship refugees sponsored by the Government of Canada individuals who have applied for refugee or immigration status
individuals for whom sponsorship has broken down.
Priority will be given to: emergency service, public health or public education workers who work in Vancouver people who currently live or work or volunteer in Vancouver. Applicants‟ monthly gross household income from all sources must not exceed five times the market rent: Unit Size One bedroom Two bedroom Three bedroom Four bedroom
Market Rent $1,501 $1,902 $2,096 $2,368
Maximum Monthly Income $9,000 $11,412 $12,576 $14,206
Applicants are required to submit proof of income with this application. Purpose of this Form This application form is designed to collect specific information from applicants seeking housing at 80 and 122 Walter Hardwick Avenue, Vancouver in accordance with the Personal Information Protection Act (PIPA) and the Freedom of Information and Protection of Privacy Act (FOIPPA) to the extent applicable. COHO uses this information to determine your eligibility for housing and the types of accommodation that best suit your needs. The information collected will only be used in accordance with the referenced legislation. Security Deposit Tenants are required to pay a security deposit equal to one-half of one month's rent as a term of the tenancy agreement. Assignment and Subletting Assignment of tenancy agreements and subletting of rental units is not permitted. Pet Policy Tenants are allowed one cat or one dog (with breed restrictions) per one-bedroom unit and up to a total of two cats or two dogs or one dog and one cat in two-bedroom and larger units. Other permissions and restrictions apply as per the Pet Policy. Tenants with approved pets are required to pay a pet deposit equal to one-half of one month's rent. COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 1 of 9
Smoke-free Housing Certain floors in both buildings are designated as non-smoking floors. Smoking is also prohibited in all common areas and on balconies and patios. The smoking policy applies to tenants and guests. Important Information COHO will not process incomplete applications. Applicants who fail to provide required information to COHO or who provide false or misleading income and occupancy verification information are ineligible for housing. Please update your application if any of your information changes. COHO reviews all applications received and will contact approved applicants to invite them to an interview as soon as a vacancy occurs. If you have any questions about completing this form, contact COHO by email at [email protected] or by telephone at 604-787-6348.
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 2 of 9
APPLICATION FOR TENANCY 80 Walter Hardwick Avenue, Vancouver 122 Walter Hardwick Avenue, Vancouver
Please answer all questions and type or print clearly. If you need extra room for any question, attach another sheet to the application. Return completed form to COHO Property Management by: Email: [email protected]
Fax: 604-879-8792
Mail: 205-5550 Fraser St, Vancouver, BC, V5W 2Z4
1. Applicant Information Person(s) asking for accommodation Last name
First name
Mr.
Home phone
Work phone
Message phone
Last name
First name
Home phone
Work phone
Message phone
Mr.
Ms.
Ms.
Mrs.
Miss
Mrs.
Miss
Home address: suite, house number, street, city, province, postal code Mailing address (if different from above):
2. Household Information 2a. List yourself, then all other household members. If required, attach separate sheet for more names. Last Name
Relationship to Applicant
First Name
Birth Date dd/mm/yyyy
Age
Sex
Born in Canada?
Yes
No
2
Yes
No
3
Yes
No
4
Yes
No
5
Yes
No
6
Yes
No
7
Yes
No
1
Self
2b. Do you expect the number of people living with you to change in the next 12 months? (e.g., pregnancy, family joining, family leaving, child in care)
Yes
No
If Yes, please explain:
2c. For each person not born in Canada, please provide the information below. COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 3 of 9
Name
Date Moved to Canada
Current Status in Canada
2d. Do all of the people listed live with you full time right now? Yes No If No, please provide the name(s) of the person(s) and number of days per week they live with you. Name
# days per week
Shared custody?
Yes
No
Yes
No
Yes
No
If not shared custody, why are they not living with you full time?
2e. Do you or any member of your household work for the City of Vancouver Police Department or Fire Department, or work for the BC Ambulance Service, in public health or in public education in the City of Vancouver?
Yes
Name
No If yes, complete the following table. Employer
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Job Title/Occupation
Page 4 of 9
3. Income Information List gross monthly income (before deductions) for all members of your household, age 19 and older, from all sources including employment, EI, pensions, income assistance, child/spousal support, etc. Do not include income of dependent children under the age of 25 attending school full-time. First Name
Source of Income
Gross Monthly Income ($)
1 2 3 4 5 6 7 Total Gross Monthly Income for Household
$
4. Health and Mobility Information To assist with matching you to housing that best suits your needs, please complete the following questions. If no member of your household has a health condition or disability, go to Section 5. 4a. Do you or any members of your household have restrictions with stairs?
No restrictions
Cannot manage stairs
Limited number of stairs (How many? _________)
4b. Do you or any members of your household use a: Wheelchair?
Yes
No
Scooter?
Yes
No
If Yes, who? __________________________________________________ If a wheelchair/scooter is used, is it used inside your home? If Yes, is it used in the kitchen?
Yes
No
Yes
No
If Yes, is it used in the bathroom?
Yes
No
4c. Other than mobility concerns, do you or any members of your household have a health condition or disability that affects your housing needs? Name
Yes
No
If Yes, please explain:
Explain the health condition or disability and describe how it affects your housing needs
4d. Please describe any special requirements or features that you may need in your housing related to mobility or any health condition.
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 5 of 9
5. Housing Preferences/Choices 5a. Accommodation size you are looking for Check one
Initial Monthly Market Rent
One
$1,601
Two
$1,902
Three
$2,096
Four
$2,368
# of Bedrooms
5b. I/we confirm that I/we are able to pay the monthly market rent listed above.
Yes
No
5c. Date for which you are looking for accommodation/are able to move in: ________________________ 5d. Do any members of your household smoke and/or require accommodation where smoking is permitted?
Yes
No
5e. There are a very limited number of parking spaces available at 80 and 122 Walter Hardwick Avenue. Parking is not included in rent and costs an additional $75 per space per month. How many vehicles do you require parking for? ________ Would you consider housing without parking?
Yes
No
5f. Do you have any pets? If Yes, how many pets in total? _______________ Provide the following information for all household pets. Type
How many
Details Breed(s):
Dog Cat Describe: Other
6. Residency History Please list your last three addresses. Address
From Date (dd/mm/yyyy)
COHO - Application for Tenancy – Market (Rev. Jan 2011)
To Date (dd/mm/yyyy)
Name of Landlord
Landlord Phone No.
Page 6 of 9
7. Commitment to Sustainability Sustainability was a priority in the design and building of 80 and 122 Walter Hardwick Avenue. For example, the buildings reuse rainwater for toilet flushing and landscape irrigation. Bathrooms and kitchens are equipped with high efficiency appliances. Large portions of the roof and courtyard areas are covered with green roofs. Composting centres will also help residents to reduce their carbon emissions. Rainwater from public spaces is collected and treated in a storm water wetland before release to False Creek. The buildings are connected to the Neighbourhood Energy Utility, a district heating system that uses sewer heat recovery for space heating and domestic hot water. Solar energy and tripleglazed windows will further reduce energy consumption. All units have in-suite energy consumption monitors so owners can regulate their energy consumption. Tenants will be required to pay a security deposit of $20 for their energy monitor. I/we are committed to helping achieve the sustainability goals at 80 and 122 Walter Hardwick Avenue.
Yes
No
8. Application Checklist: Before returning your Application for Accommodation, have you:
Completed your Application in full? Enclosed the following documents, if applicable: Proof of Canadian citizenship or immigration status for all household members If you neither live nor work in Vancouver, a letter from the organization you volunteer with, if applicable, confirming your status as a volunteer Proof of income from all sources (Notice of Assessment for previous year; if employed, last three consecutive pay stubs or letter from employer; if self-employed, copy of Statement of Business Activities and Income Tax Return) Copies of cheque stubs, bank statements showing direct deposit of pensions, or other confirmation of income for any other income source Proof of student status for household members age 19 to 24 who attend school full-time Copy of the „Notice to End a Residential Tenancy‟, if applicable
Signed and dated the Application in the shaded space below? Completed Schedule “A”, attached?
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 7 of 9
DECLARATION: Please read and sign this statement. The applicant(s) and all adult household members (anyone 19 and older) must agree to the following:
I/We declare: This is my application and/or verification form; and All the information in it is correct and complete to the best of my knowledge and belief. I/We authorize: Pursuant to the Personal Information Protection Act (PIPA) and the Freedom of Information and Protection of Privacy Act (FOIPPA) to the extent applicable, COHO Property Management (COHO) to make any inquiries that are necessary to verify the information given in this application; and Pursuant to PIPA and FOIPPA to the extent applicable, any person, corporation or social agency to release to COHO any information pertinent to the assessment of my/our application; and COHO to 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 this application does not constitute any agreement on the part of COHO to provide me/us with rental accommodation; and That it is my/our responsibility to advise COHO of any changes to the information given in this application and to provide any supporting materials required for my/our application; That the provision of false or misleading information is grounds for ending tenancy; and That if it is necessary in order for COHO to perform a credit check, I/we will be required to provide my/our Social Insurance Number(s) in order for my/our tenancy to be considered. Signature of Applicant
Date
Signature of Applicant
Date
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Page 8 of 9
SCHEDULE “A” COHO CREDIT REPORTING SERVICE To allow COHO to obtain a credit report, please complete the following information. Type or print clearly and include your postal code(s). Only complete the information for the Co-Applicant if a credit check is being done for them; otherwise leave it blank. This form is for information only, and a credit check cannot be completed without the signed Declaration on page 7 of the Application for Tenancy (must also be signed by the Co-Applicant if applicable). Credit checks will be performed only for applicants whose tenancy is under consideration following an interview.
APPLICANT First Name
Middle Name(s)
Mr.
City
Province
Postal Code
# of years
Last Name
First Name
Middle Name(s)
Mr.
Province
Postal Code
# of years
Last Name
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Ms.
Mrs.
Miss
Current Address
Previous Address City Date of Birth (YYYY-MM-DD)
Social Insurance Number (optional)
CO-APPLICANT First Name
Middle Name(s)
Mr.
City
Province
Postal Code
# of years
Last Name
First Name
Middle Name(s)
Mr.
Province
Postal Code
# of years
Last Name Current Address
Previous Address City Date of Birth (YYYY-MM-DD)
COHO - Application for Tenancy – Market (Rev. Jan 2011)
Social Insurance Number (optional)
Page 9 of 9
