Old Grace Housing Co-operative

Old Grace Housing Co-operative Suite Application Form (Pre-construction) Applicant #1 Name: Applicant #2 Name: Please check the list of Currently Available Suites on the OGHC website. A. I/We are applying for one of the currently available suites. First choice: Second choice: Is there any other information about your suite choice that you want the co-op to know? In addition to suites available in the main housing complex, the master plan for OGHC includes the development of ten 1 bedroom units of affordable housing on the adjacent site of 905 Preston Avenue. The design and approval processes for this second site are being initiated now, with the goal of simultaneous occupancy of both sites (early 2018). Members interested in 1 BR units will be informed as soon as the application window for these suites opens. B. I/We are completing this application form in order to have my/our names added to the Waiting List for suites. Before completing this application form: Please review the floor plans, unit plans, share prices, occupancy charges and other information about the co-op and the housing complex. Click on Suites from the website home page. Information about the co-op s policies can be found from the website home page by going to About > Governance > Policies and House Rules. 1

OLD GRACE HOUSING CO-OPERATIVE Personal Information Protection - Consent Statement 1. I/we agree that Old Grace Housing Co-operative may keep the following information about me / our household on file: Household contact information Medical information (disability) Present housing situation Record of co-op loan & repayment Household size and composition Pet information Household income 2. I/we understand and agree that the co-op will use the information to: Contact me/us about this application. Determine my/our eligibility for co-op membership and occupancy. Determine if I/we qualify for housing assistance (access to affordable housing; occupancy charge subsidy). 3. I/we agree that this personal information may be made available to the following people, only as it relates to my/our application, and only on a need-to-know basis: OGHC Membership Committee OGHC Finance Committee OGHC Board of Directors Manitoba Housing 4. I/we understand that the co-op will destroy personal information that has been collected as soon as it is no longer needed. 5. I/we understand that the full text of OGHC s Protection of Personal Information Policy is available on the public pages of the co-op s website (www.oldgracehousingcoop.ca) 6. I/we have read and received a copy of this statement. Applicant #1 Signature Date Applicant #2 Signature Date 2

PRE-CONSTRUCTION UNIT APPLICATION FORM This form is for use by Interim Members who wish to become initial residents of the co-op, once the housing complex is built. A. Definition of Interim Member 1. Since 2012, individuals in favour of developing a housing complex at 189 Evanson Street have joined Old Grace Not-for-profit Housing Co-operative as Interim Members. Each Interim Member has paid a fee of $50 (representing 1 Member Share in the co-op) to support the project s development. 2. When joining OGHC, applicants for Interim Membership were asked to verify that they: were in agreement with the general principles of the co-operative movement and those which apply specifically to OGHC. supported the principle of consensus decision-making, and the expectation that members participate as fully as possible in decision-making and in the volunteer work required for co-op operations. understood that Interim Membership would not automatically guarantee them a housing unit in the co-op s housing complex. B. Unit Application Requirements 1. For pre-construction unit applications, the person completing the application form on behalf of the household must already be an Interim Member of the co-op. 2. Other adults living in the applicant s household are encouraged to complete the online Membership Application and submit their $50 fee. This will enable them to participate fully in all co-op meetings while the housing complex is being built. At co-op meetings, decisions are normally made by consensus. When voting is necessary, votes are counted on a one-member-one-vote basis. 3. All persons in the applicant s household who are 18 years of age or older, and who are not dependents, are expected to apply for individual membership before moving into the co-op. Proof of individual co-op membership will be required at that time. 4. Dependents (eg adult children, elderly parents) may apply for long-term guest status instead of full coop membership. Long-term guests can attend all co-op meetings but cannot participate in decisionmaking. Please email the Membership Committee at oldgracehousingcoop@gmail.com - if you have any questions about this application form, or need assistance completing it - if you need information provided in an alternate format, or - if you need to have your completed application form collected, or - if you have any concerns about financing your Member Share. When you have completed the application form, please make a copy for your own records. 3

PART 1: INFORMATION ABOUT YOUR HOUSEHOLD 1. Please list the adults in your household who are/will be applying for unit occupancy: Applicant #1 I confirm that I am an Interim Member Last Name: First Name: E-mail address: Phone (1): Phone (2): Mailing Address (including postal code): Please contact me using (give preference): email Phone 1 Phone 2 Other instructions: Applicant #2 Are you an Interim Member? Yes No Last Name: First Name: E-mail address: Phone (1): Phone (2): Mailing Address (if different from above): Please contact me using (give preference): email Phone 1 Phone 2 Other instructions: 4

2. Please list all the other members of your household who will occupy the unit with you. Name (First, Last) Relationship Age now (years) 0-5 5-17 18+ PART 2: INFORMATION ABOUT YOUR HOUSING NEEDS You are eligible for affordable housing if your household income (Line 150 from each adult s income tax return) is below the Program Income Limits set by MHRC. These limits are adjusted each year (see Share Prices and Occupancy Charges under Suites on the OGHC website). 1. What kind of housing are you applying for? Market housing Affordable housing Affordable housing & rent supplement (RGI) 2. What size of unit are you requesting? 1 bedroom 2 bedrooms 3 bedrooms 4 bedrooms Note: If you are applying for market housing, no occupancy ratios are applied. However, to maintain the multi-generational nature of the co-op, OGHC will only allocate 4 BR units to households of 4 or more persons. If you are applying for affordable housing, you are eligible for 1 bedroom per occupant (2 people or 1 couple = 2 bedrooms; 3 people = 3 bedrooms; 4 people = 4 bedrooms). If you are applying for affordable housing with rent supplement (RGI), there are more restrictions. A couple is expected to share 1 bedroom, and children under 18 years old (of the same gender) are expected to share rooms (2 per bedroom). The master plan for OGHC includes the development of ten 1 bedroom units of affordable housing on the adjacent site of 905 Preston Avenue. The design and approval processes for this second site are being initiated now, with the goal of simultaneous occupancy of both sites (early 2018). 5

3. Is any person in your household living with a disability or living with a medical condition that affects their housing needs? Yes No If yes, please describe what unit adaptations are needed: 4. Do you require a parking space? In addition to the parking spaces at 189 Evanson, there will be some parking spaces associated with the development of 905 Preston. It is our intent to make parking available for OGHC residents on both sites. I/We have read and understand the OGHC Parking Policy and agree that my/our household will follow it. I/We do not require a parking space I/We are applying for a parking space for 1 vehicle. There will be two PegCity Car Co-op vehicles located on site. As an incentive to living car free, every Old Grace Housing Co-op member who joins PegCity Car Co-op will receive a $75 driving credit (equivalent to one year s annual fee and application fee) for no charge. I/We would like more information about PegCity Car Co-op and the offer of $75 credit for OGHC members. Some members of the co-op are interested in exploring other alternatives to private vehicle ownership. I/We would like more information about private car-sharing with another co-op resident. 5. The co-op welcomes well-behaved pets. I/We have read and understand the OGHC Pet Policy and agree that our household will follow it. I/We do not have any pets at present. I/We have the following pets: Pet Type Number 6

I/We understand that I/we must provide rabies vaccination information for dogs or cats prior to moving in. 6. The co-op is a completely smoke-free community. I/We have read and understand the OGHC No-Smoking Policy and agree that our household will follow it. 7. OGHC members are expected to take part in co-op life. I/We have read and understand the expectations of co-op members as detailed in OGHC House Rules - Member Involvement. I/We agree that our household will contribute an average of 8 hours per month towards the co-op (by involvement in social activities, work groups, committees and the board). I/We agree to participate in making decisions that affect co-op life by attending the Annual General Meeting and all other membership meetings. PART 3: CO-OP FACILITIES AND UNIT FEATURES 1. To meet overall accessibility standards, all units have a bathroom fitted with a walk-in shower. 2. All units have a dishwasher hookup supplied in the kitchen (see unit plan for location) 3. All units have a washer/dryer hookup supplied in the storage room (see unit plan for location). Members can have a washer and vent-less dryer supplied by the co-op s contractor (appliances are at member expense). The prices are estimated to be about $1,000 for a washer and $1,250 for a vent-less dryer (a type that is not connected to the outside). Appliances that are supplied by the contractor must be paid for at the same time as the cost of any unit customization (early 2017). If members choose to buy their own appliances, these will be installed after occupancy, at the members expense, by the members own supplier. The co-op will need proof that the appliances meet Energy Star standards (to make sure our building s energy-efficiency targets are met). 4. The co-op will have a sunny communal laundry, next to the 2 nd floor member lounge. Many co-op members are interested in sharing resources, rather than buying their own appliances. There will a small charge per load for laundry (smart-card system) PART 4: UNIT ALLOCATION PROCESS PRE-CONSTRUCTION 1. Waiting lists will be established for each type of housing and size of unit. Priority on the Waiting List will be based on the date that Interim Members paid their one-time fee to become supporters of the co-op. 2. If there is more than one Interim Member in the household, with different dates of joining the co-op, the earlier date of co-op membership will be used. 7

3. The Membership Committee will supervise the process of allocating any available units to applicants. If an applicant s first choice of unit is unavailable, his/her second choice of unit will be allocated. 4. In the event that neither of the applicant s choices is available, the applicant will be contacted by the Membership Committee and given the opportunity to select another unit from any still available. 5. If the applicant is not allocated one of the available units, he/she may choose to keep his/her name on the Waiting List, in the event another suitable unit becomes available before the building is completed. PART 5: FINANCIAL AGREEMENT No deposit needs to be paid to have your name added to the Waiting List. A. DEPOSIT FOR A CURRENTLY AVAILABLE UNIT: Market unit $2500 Affordable unit $1000 Affordable unit (RGI) $500 I/We understand that a deposit must be provided with this application to confirm my/our sincere interest. I /We have attached a cheque / money order for my / our full deposit $ I /We have made an e-transfer to oldgracehousingcoop@gmail.com for $ I/We understand that this deposit is fully refundable if a unit cannot be allocated. B. PROOF OF ELIGIBILITY FOR AFFORDABLE HOUSING: No proof needs to be provided to have your name added to the Waiting List. If an affordable unit becomes available, you will be asked for the information then. MHRC requires OGHC to verify and record the total annual gross household income of all applicants for affordable housing, before allocating units. Each member of your household aged 18 years or older must send the Membership Committee a Certified Income Tax Return (Option C) for the most recent tax year. If you have not filed your 2015 income tax, please request your 2014 tax return. Please call Canada Revenue Agency at 1-800-959-8281 and speak to a representative to get this document. You will be asked to prove your identity by giving your SIN Number, date of birth etc. The document will be mailed to you in 8-10 working days. You can send in your completed application form without the Certified Income Tax Return as long as you mail it to the OGHC Membership Committee as soon as you receive it. The Co-op must know that you are eligible for affordable housing before you sign the Offering Statement. C. PAYMENT OF MEMBER SHARES: I/We understand that the Member Shares for currently available units are payable in full on 17 May 2016. I/we shall sign the Offering Statement at this time, which represents a legal commitment to invest in the co-op housing project. 8

Note: For unit allocations made after 1 May 2016, Member Shares will be payable within 21 days. I/We understand that my/our Member Shares are held in trust until released by the Manitoba Registrar of Co-operatives. I/We understand that my/our Member Shares can only be withdrawn before the housing complex is completed if another investor can be found. This transaction will only be permitted if the amount of capital available to the co-op for construction is not reduced. Declaration I/We declare that all information on this application is true and correct and hereby authorize OGHC or its representative to verify any and all of the information herein, including information relating to family members, spouses, partners and/or roommates as detailed herein. I/We hereby agree to comply with the terms of the general bylaws, rules and regulations, housing agreements and operating policies of Old Grace Housing Cooperative for its members. I/We declare that I/we understand and agree that any misrepresentation such as under-declaration of household income, provision of incorrect financial information, failure to disclose the true number of people residing in my household, and other similar acts will give OGHC enough valid reason to cancel my/our membership in the co-op. Signatures of all adult applicants for unit occupancy: Applicant #1 Signature Date Applicant #2 Signature Date Return your completed unit application form to: Membership Committee Old Grace Housing Co-operative c/o DSI Tandem Co-op Resources Ltd. Unit 303 93 Lombard Avenue, Winnipeg, MB. R3B 3B1 Applications can be mailed to this address, or dropped off during office hours (Mon-Fri 8:30-4:30). Contact OGHC by email if you need your application picked up. 9