MERCHANTS CORNER HOUSING

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MERCHANTS CORNER HOUSING APPLICATION REQUIREMENTS REQUIRED DOCUMENTS FOR APPLICATION: Prior tax year Option C Revenue Canada 1 800 959 8281 Photo identification all adults Proof of income current pay stubs, pension statement, EIA budget letter Confirmation of Enrollment in Education Institution registration receipt, time table $22.00 for a credit history report. To obtain your own contact TransUnion NEW CANADIANS Applicant not holding Canadian citizenship provide a IMM1000, IMM5292 or IMM1442 for each member of the family Once application is approved your application will be put on a waiting list. Should any of your information change, it is your responsibility to notify WHRC. Ie: change of phone number. When an apartment becomes available, you will be contacted to view within 2 days. Full security deposit (1/2 of market rent) is required to hold suite after viewing and accepting. Lease signing appointment will be arranged with your Property Manager prior to move in. RETURN ALL DOCUMENTS IN PERSON TO: WINNIPEG HOUSING REHABILITATION CORPORATION 104 60 FRANCES STREET WINNIPEG MANITOBA R3A 1B5

WINNIPEG HOUSING 104-60 Frances Street, Winnipeg, Manitoba R3A 1B5 Phone: 204-949-2880 MERCHANTS CORNER - APPLICATION FOR HOUSING (Please print) APPLICANT: (first name) (initial) (last name) Social Insurance #: Date of Birth: Phone Res. Cell Phone: Work Phone Current Address Rent Own City/Town: Province: Postal Code: Name of Landlord: Phone Number: Employment Status: Employed E.I. EIA Pension Employer: Are you a Canadian Citizen? YES NO Marital Status: Married Common Law Single Widow(er) Divorced (Spouse/co-applicant please complete the following) Spouse/co-applicant: (first name) (initial) (last name) Social Insurance # Date of Birth: Employment Status: Employed E.I. EIA Pension Employer: DECLARATION OF GROSS MONTHLY INCOME ATTACH ALL SUPPORTING DOCUMENTS FOR EACH INCOME EARNER AND SOURCE OF INCOME. DATE APPLICANT CO-APPLICANT/SPOUSE Page 2 of 7

Indicate by YES or NO which of the following are included in your rent: Heat Hydro Water Fridge Stove Parking Furniture Other Do you require accessible housing? YES NO APPLICANT Receiving Employment & Income Assistance Benefits Worker s Name Office Location Worker s Phone Number Worker s Email Case Number FAMILY INFORMATION List all persons who will be living in the household. NAME BIRTHDATE GENDER M/F RELATIONSHIP Next of Kin: (in case of emergency) Name: Relationship: Address: Phone: Name: Relationship: Address: Phone: LANDLORD INFORMATION: APPLICANT: Previous Address: Name of landlord: Phone Number: Length of tenancy: Page 3 of 7

If less than 5 years at above address Previous Address: Name of Landlord: Move in date: Move out date: AUTHORIZATION AND DECLARATION I/we understand this application does not constitute an agreement on the part of Winnipeg Housing Rehabilitation Corporation or its agent to provide me/us with rental accommodation. I/we acknowledge this application becomes the property of Winnipeg Housing Rehabilitation Corporation upon delivery by me/us to it or its agent. I/we further acknowledge the right of Winnipeg Housing Rehabilitation Corporation or its agent at any time prior to the execution and delivery to me of a lease hereby applied for, to withdraw, revoke, or cancel, without penalty or liability for damages or otherwise, any acceptance or approval of this application previously made or given. I/we certify the information given in this application is true, correct, and complete in every respect fully disclosing my/our income from all sources. False information will result in this application being declined or will terminate your tenancy once you move in based on false information. Personal information is collected by Winnipeg Housing Rehabilitation Corporation and will be used to establish eligibility for rental housing. It is protected under The Personal Information protection and Electronic documents act (PIPEDA). I/we hereby authorize Winnipeg Housing Rehabilitation Corporation to conduct a personal investigation including past and present landlord reference checks. Applicant name: Co-Applicant name Applicant signature Co-Applicant/Spouse Date Page 4 of 7

WINNIPEG HOUSING REHABILITATION CORPORATION 104-60 FRANCES STREET, WINNIPEG, MANITOBA R3A 1B5 TRANS UNION OF CANADA, INC CONSUMER RELATIONS INFORMATION FORM TO ENABLE OUR CONSULTANTS TO ID YOUR FILE PLEASE COMPLETE THIS FORM IN FULL. PLEASE PRINT NAME: FIRST MIDDLE LAST NAME OF SPOUSE: TELEPHONE #: DATE OF BIRTH: SOCIAL INSURANCE #: CURRENT ADDRESS: APT: CITY: PROV: POSTAL CODE: HOW LONG AT THIS ADDRESS?: YEARS: MONTHS: PREVIOUS ADDRESS: APT: CITY: PROV: POSTAL CODE: HOW LONG AT THIS ADDRESS: PRESENT/PREVIOUS EMPLOYER: LEMGTH OF EMPLOYMENT: WERE YOU REFUSED CREDIT AT ANY TIME: YES NO IF YES, PLEASE LIST: NAME OF COMPANY: CONTACT: TELEPHONE #: FAX #: I AM THE PERSON NAMED ABOVE AND I UNDERSTAND I COULD BE PROSECUTED UNDER FEDERAL OR PROVINCIAL LEGISLATION FOR OBTAINING INFORMATION FROM A CONSUMER REPORTING AGENCY BY FRAUDULENT MEANS OR UNDER FALSE PRETENCES. SIGNED: DATE: FOR OFFICE USE ONLY OPERATOR: CODE: DATE: REGULAR: RUSH: TIME: ID 1: ID 2: Page 5 of 7

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