77 Mill Street Tenant Application Form

Address: 77 Mill Street, Nanaimo BC

Property Details

If you need assistance filling out your application, please consider the following local resources:

Public computers and printing available at Vancouver Island Public Library:

90 Commercial St Nanaimo, BC V9R 5G4 Phone: 250-753-1154. (10 public computers, 15–30-minute time limits, printing available)

In-person support by staff at:

Nanaimo Disability Resource Centre –
#2-4166 Departure Bay Rd, Nanaimo, BC V9T 4B7
Phone: 250-758-5547
Nanaimo Family Life Association –
1070 Townsite Rd Nanaimo, BC V9S 1M6
Phone: 250-754-3331

Please have your reference information, residency history, and co-applicant ready to sign before beginning.

Step 1 of 10

Date(Required)

Name(Required)

Prefix First Middle Last

Preferred Name

Home Phone(Required)

Mobile Phone(Required)

Email(Required)

Enter Email Confirm Email

Seniors (55+) Housing Sought(Required)

1 Bedroom

1 Bedroom (accessible suite)

Status(Required)

Canadian Citizen

Permanent Resident

Landed Immigrant

Refugee Status

Do you wish to receive correspondence by email?(Required)

Yes

Current Home Address(Required)

Street Address Address Line 2 City Province Postal Code

Mailing Address

Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BC Housing File Number

DECLARATIONS: (please read and sign this statement)

Ballenas Housing Society with BC Housing:

The landlord has entered into an agreement with BC Housing designating the residential property as housing for low to moderate income households. Income testing is required and will be completed in compliance with the standards set by BC Housing.
The following standards will apply:

No more than two (2) and no less than one (1) person per bedroom.
Spouses and couples share a bedroom.

The Applicant Declares the Following:

I/We declare:

This is my application; and
I/We consent to the use of this information for the purposes of matching the housing (potentially available) within the Ballenas portfolio, with my/our needs.
All the information provided in this application is correct and complete to the best of my knowledge and belief.
I/we further state that in terms of physical condition I/we can care for myself/ourselves.

I/We authorize:

Pursuant to the Personal Information Protection Act (PIPA) and the Freedom of Information and Protection of Privacy Act (FOIPPA), Ballenas Housing Society to make any inquiries that are necessary to verify the information given in this application; and
Pursuant to PIPA and FOIPPA, any person, corporation or social agency to release Ballenas Housing Society any information pertinent to the assessment of my/our application; and
Ballenas Housing Society 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:

This application does not constitute any agreement on the part of Ballenas Housing Society to provide me/us with rental accommodation;
Preference will be given to applicants who are current residents of Nanaimo;
77 Mill Street is a non-smoking building and a non-smoking agreement will need to be signed prior to the commencement of the tenancy; and
It is my/our responsibility to advise Ballenas Housing Society of any changes to the information given in this application and to provide any supporting materials required for my/our application. (Note: Providing false or misleading information will result in the cancellation of your application.)
Ballenas Housing Society requires three (3) references to be provided with an application before it can be reviewed.

Application must be signed by all applicants over the age of majority.

Please confirm how many applicants are applying(Required)

Applicant Signature:(Required)

Co-Applicant's Name

First Last

Co-Applicant's Signature:

Date Signed(Required)

SUBMISSION

AUTHORIZATION TO COMPLETE CREDIT CHECK

I/We hereby warrant that all representations set forth above are true. To verify the above statements, I/We direct those persons named as references in this application to ask questions about me/us.
I/We waive all rights of actions for consequences as a result of such information.
I/We agree and authorize and give permission to Ballenas Housing Society to perform a credit check on me/us.

Applicant's Initials(Required)

I/We hereby warrant that all representations set forth above are true. To verify the above statements, I/We direct those persons named as references in this application to ask questions about me/us.
I/We waive all rights of actions for consequences as a result of such information.
I/We agree and authorize and give permission to Nanaimo Affordable Housing Society to perform a credit check on me/us.

Co-Applicant's Initials

Type n/a if no co-applicant is applying.

Phone

This field is for validation purposes and should be left unchanged.