Affordable Housing Rental Application

Tipton Place Rental Application

Please ensure that you have completed the entire form.
Applicant's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
How many bedrooms are you looking for?
Do you have rent assistance?
If yes, who helps pay your rent?
Current Housing Information
What is your current living situation?
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have lived at your current address?
Reason(s) for leaving for your current address?
Current Landlord Name

First NameLast Name
Current Landlord Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Occupants of the Unit
List the total number of people who will occupy the property (including yourself)
Please list the names and information of everyone who will live with you in the unit. If you plan to live with a roommate, write "Roommate" in Relationship. You only need to submit one application for the two of you.
Do you expect the number of people in your family to change in the next 12 months?
If yes, please explain
Income Information
Eligibility for tenancy is based on the income of all household members over the age of 19. Please submit a Declaration of Income with this application. Include all supporting documents.
Attach your Declaration of Income and any other supplementary documents here.

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Vehicles
Do you have a Vehicle?

Do you have a current SPARC pass?
Pets
Do you have pets?
Is your pet a service animal?
If yes, please upload documents

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Please include all of your pets below
I am willing to find a new home for my pet
Accessibility
Do you have physical accessibility needs?
If yes, please fill out the accessibility needs form
Are you eligible for Community Living B.C. (CLBC) funding?
If yes, please include a letter from CLBC confirming your eligibility

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Housing History
Please list all previous housing from the last two years. If you have not previously rented, please include two references.
References
Name of Reference #1

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Relationship to you
Name of Reference #2

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Relationship to you
Support Worker

If you have a support worker, interpreter, advocate, or another person we talk to who is helping you in your housing search, please list them below.
Name

First NameLast Name
Organization
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Click each box below to acknowledge you have read and agree to each statement.
Name

First NameLast Name
Applicant's Signature
Date Signed

MonthDayYear
Please verify that you are human
Should be Empty:

Tipton Place Rental Application