1Applicant2Contact3Household4Status5Miscellaneous6References7Documents8SignatureApplicant InformationLast NameFirst NameDate of Birth MM slash DD slash YYYY Add Co-Applicant? YesLast NameCo-ApplicantFirst NameCo-ApplicantDate of Birth MM slash DD slash YYYY Co-ApplicantContact InformationHome AddressCityProvincePostal CodeEmail(Required) Home Phone(Required)Work PhoneCell PhoneUse a different mailing address? YesMailing AddressCityMailingProvinceMailingPostal CodeMailingEmergency ContactContact NameAddressPhoneRelationshipHousehold InformationList all other household members that will be residing with.Household membersLast NameFirst NameRelationshipDOB: MM/DD/YYAgeGender Add RemoveUse the + button to add household members.Are you expecting the number of people living with you to change within 12 months? Yes NoIf yes, please explainStatusDo you or anyone in your household identify as being an Indigenous person? Yes NoIf yes, please select First Nation Inuit MetisIf First Nation please provide your First Nation Band & Status Number(s) for everyone:NameBandTreaty Number Add RemoveAdditional InformationFor all other income, list gross monthly income (before deductions) for tenants 18 years & older.First and Last NameGross Monthly (Employment, El, Pension, etc.)Income Source ($) Add RemoveIf any 18 or older is a full-time student, attach letter of funding to application.Do you have a pets? If yes, what types:PETS ARE NOT ALLOWED AT OUR SWIFT CURRENT LOCATIONS AND PARK STREET LOCATION IN REGINACan you maintain a yard? Yes NoIf yes, do you have tools to maintain a yard? Yes NoDo you or any of your family members have a disability? If so please explain:Please list below if there is any other relevant information that we should know about:Residency History & ReferencesPlease provide information on your last two landlords.First LandlordLandlords NameRental Address(street, city)PhoneFrom Date MM slash DD slash YYYY To Date MM slash DD slash YYYY Rent Cost?Reason for leavingSecond LandlordLandlords NameRental Address(street, city)PhoneFrom Date MM slash DD slash YYYY To Date MM slash DD slash YYYY Rent Cost?Reason for leavingDocumentsNo Application will be processed without the following informationPlease attach the following documents by dragging the files to the Files section below. 2 Written Landlord References, or a Character Reference (Cannot be from family member) Proof of Income: Pay/Cheque Stub Current Tax Assessment from each household member over the age of 18 Copy of current Utility Bill (Power, Water & Energy) Government ID or Treaty Status for Applicants & Dependents Proof of Legal Guardianship or Custody of Dependents (Provincial or Federal documentation)Files(Required) Drop files here or Select filesAccepted file types: jpg, png, pdf, Max. file size: 5 MB, Max. files: 20.SignaturePlease note, after 2nd offer of a unit is refused, your application will be cancelled and you will have to reapply.I declare that the information given by me/us to be complete and correct. I understand that this application/personal statement does not constitute or guarantee acceptance as a Tenant of Silver Sage’s Housing CorporationApplicant SignatureCo-Applicant SignatureCAPTCHA
