Affordable Housing Program Application Airdrie Housing Limited respects your right to privacy; all documentation requested is done so that we may efficiently review an applicant s financial needs and qualify them for programs as applicable. Once complete, the application should be returned to Airdrie Housing Limited in one of the following ways: In Person: Visit Community Links at 105 104 First Avenue NW, Airdrie and meet with an intake worker to ensure your application is complete. Office hours are: Monday, Tuesday and Wednesday from 8:30 a.m. to 4:30 p.m. Thursdays from 8:30 a.m. to 8 p.m. Fridays from 8:30 a.m. to 4 p.m. Please note the office is closed daily from noon to 1 p.m. If this is not convenient, completed applications may also be: Mailed to: Application Assessment Airdrie Housing Limited c/o Community Links 211, 125 Main Street Airdrie, AB, T4B 0P7 Faxed to: Application Assessment Airdrie Housing Limited 403-948-0226 This application includes a lot of information and is intended to answer many of your questions about Airdrie Housing programs while gathering the information which Airdrie Housing Limited needs in order to properly assess your eligibility for our programs. Please read and complete this application carefully.
Affordable Housing Application P a g e 2 o f 16 Application Checklist Please review the following checklist for documents APPLICABLE to your financial situation and include copies with your application. Ensuring all applicable documents are included will allow Airdrie Housing Limited to process your application more quickly and efficiently. Proof of income Two most recent paystubs Most recent AISH cheque deposit information Most recent Income Support cheque deposit information Most recent deposit information for Canada Pension Plan, Old Age Security or Disability Pension income Written confirmation of wages from your employer 30-day Bank statement illustrating any other sources of income, such as the Child Tax Benefit, child support, spousal support, or Employment Insurance. Notice of Assessment for adults attending post-secondary institutions Acceptable proof of citizenship and identity Applicants who are not Canadian Citizens must provide copies of Long Landing Papers illustrating the date on which their stay in Canada expires. Applicants accepted for the program will be asked to show picture identification, preferably a driver s license, at the time that the agreements are signed. Some form of identification must be seen for dependant children and adults in the family. Acceptable proof of current rental situation Copy of current, signed lease agreement illustrating: the applicant s name; the landlord s name; rental unit address; rental amount; term of lease; utility payment information Notice of rent increase Eviction Notice Notice of rental arrears Assets and Loans Provide documentation regarding vehicles (owned, leased or car loans) stocks, bonds, term deposits, mutual funds, cash business equity property Provide documentation regarding any automatic loan payments taken from your bank account. Agreements Read and sign the Declaration, Confidentiality Agreement and complete and sign the Consent for Release of Information ensuring to list the contact information for your current landlord AND/OR employer AND/OR case worker. Important Note: Please do not provide copies of identification for yourself or household members. Airdrie Housing staff members will ask to see identification when signing an agreement.
Affordable Housing Application P a g e 3 o f 16 Frequently Asked Questions What is Affordable Housing? Airdrie Housing Limited owns more than 40 Affordable Housing units in Airdrie, including apartments and apartment-style condominiums. These units are rented at 10% below market value; Airdrie Housing does not offer subsidized housing, in which rents are geared toward the household income. Subsidized housing is offered by Calgary Housing Company, which operates some units in Airdrie. Airdrie Housing strives to meet client housing needs to the best of our ability; however, crisis or emergency housing is not provided as part of our mandate. If you are in immediate need of housing due to an eviction or other crisis circumstances, please contact one of the following agencies. Crisis Support and Services Address Contact Referral Agencies Community Links Crisis support, intake services and referrals 105 104 First Avenue NW, Airdrie 403.945.3900 www.nrvcl.ab.ca Distress Centre 24-hour crisis support and referrals. 403.266.HELP (4357) Shelters in Calgary Population Served Address Contact Inn from the Cold Families 106 110 11 Avenue SE 404.263.8384 Salvation Army Centre Men 420 9 Avenue SE 403.410.1111 of Hope Drop-In Centre Adults segregated sleeping areas 1 Dermot Baldwin Way 403.266.3600 SE Mustard Seed Adults 102 11 Avenue SE 403.269.1319 EXIT Homeless Youth Shelter Youth 112 16 Avenue NE 1.800.563.6106 or 403.509.2323 Alpha House Shelter for adults under the 203 15 th Avenue SE 403.234.7388 influence of drugs or alcohol Avenue 15 Youth Youth 938 15 Avenue SW 403.543.9651 Shelter Mary Dover House Women 320 5 Avenue SE 403.263.1550 (YWCA) Calgary Women s Emergency Shelter Women and children fleeing abuse _ 403.234.SAFE (7233) Awo Taan Healing Lodge Women and children fleeing abuse _ 403.531.1972 or 403.531.1976 Sherriff King Home Women and children fleeing abuse 2003 16th Street SE 403.266.0707 (YWCA) Wheatland Shelter Women and children fleeing abuse Strathmore 1.877.934.6634 Sonshine Community Women and children fleeing abuse _ 403.243.2002 Services Shelter Kerby Centre Shelter Seniors 60+ fleeing abuse _ 403.705.3250
Affordable Housing Application P a g e 4 o f 16 Who qualifies for an Affordable Housing Unit? Applicants who qualify for an Airdrie Housing Affordable Unit must: Be in core housing need, as determined by the table below which outlines the Core Needs Income Threshold (CNIT) figures for 2014 in Airdrie, as determined by the Government of Alberta. Unit type needed by client Maximum Qualifying Income Bachelor Suite $35,500 or less 1 Bedroom $43,000 or less 2 Bedroom $51,000 or less 3 Bedroom $55,000 or less 4 Bedroom $58,500 or less 5+ Bedroom $61,500 or less Disclose all assets under the name of all adults who will be living in the unit. Be either a Canadian citizen OR a person permitted into Canada lawfully for permanent residence OR a refugee sponsored by the Government of Canada OR an individual who has applied for refugee or immigration status and for whom private sponsorship has broken down. Supporting documentation must be provided. Such factors as dependant children, what the applicant is currently paying in rent and suitability of current housing are considered during the application process. How will I know if I qualify for an Affordable Housing unit? Applicants will be contacted by Airdrie Housing Limited as to the status of their application either by phone, email or letter. Please note that although you may qualify, there are a limited number of units and they will be filled according to highest priority of need. For how long will I be entitled to the Affordable Housing unit? Once qualified, clients are required to sign a fixed-term lease. When the lease term expires, if the client continues to qualify and there have been no significant tenancy issues, the lease can be renewed.
Affordable Housing Application P a g e 5 o f 16 Prospective Tenant Information As a prospective Airdrie Housing tenant, there are some things we would like you to consider and plan for in the event you become a tenant. Please carefully review the following information. 1. Airdrie Housing requests that all tenants carry CONTENT INSURANCE on their belongings. This is because Airdrie Housing s insurance DOES NOT replace tenant belongings in the event of damage, such as from a flood or fire. 2. Airdrie Housing is rarely able to provide more than 30 days notice that an Affordable Unit is available. Applicants are advised to investigate possible penalties for breaking their current lease agreements should they have to make such a decision. 3. Once offered an Affordable Housing unit, the process is as follows: Airdrie Housing and the client will sign an agreement in which the client agrees to move into the unit within 30 days. The move-in date is scheduled with the property manager. 4. On the MOVE-IN DAY, the client and the property manager will: Complete the walk-through inspection Sign the fixed-term lease 5. The client must provide the property manager with the following: A CERTIFIED CHEQUE for the damage deposit (equivalent to one month of rent); A cheque for the first month s rent Post-dated cheques for the remainder of the lease term. 6. Clients must pay for their own ELECTRICITY and as it can take several days to have your current utility account transferred to your new address or a new account created we advise prospective tenants to look into this process ahead of time. 7. If anything in your application changes once it has been submitted (i.e. there is a new family member or new income) please contact Karen Lazaruk at 403.945.3900 or karenl@nrvcl.ab.ca to advise of the changes.
Affordable Housing Application P a g e 6 o f 16 Household Information Name of Applicant (include maiden name if applicable) Date of Birth (MO/DD/YR) Marital Status (please circle) Home Phone Number Work Number Cell phone number Email address Single Married Cohabitating Divorced Separated Widowed Independent Youth Address Are you a Canadian Citizen? YES NO City, Province and Postal Code If not, you must provide copies of your LONG LANDING PAPERS outlining when your permanent residency expires. Additional Tenants: Please list the names and dates of birth for the other members of the household. First and last name Date of Birth (MO/DD/YR) Gender Relationship to applicant Post-Secondary Education Is any member of the household over the age of 18 attending school? Yes (Please provide proof of enrollment for the current school year) No Is there anything else you wish Airdrie Housing Limited to understand about your current financial, employment/income situation?
Affordable Housing Application P a g e 7 o f 16 Current Living Situation & Employment Information Have you been asked to leave your current address? YES NO Do you have an eviction notice? (If yes, please attach a copy) What are you currently paying in rent? $ Are you currently paying separately for heat, electricity or water? YES NO YES (if yes, please circle which) NO What type of unit are you residing in? (apartment, condo, shelter etc.) How many bedrooms? Are you renting from a family member? YES NO Are you currently living in low-income or subsidized housing or receiving a rental supplement? YES NO Do you have any pets? YES NO If yes, please describe the size and breed of each animal: If yes, please name the program or service provider: Are you able to climb stairs? YES NO Are you willing to find a new home for your pet(s)? YES NO Do you have any accessibility requirements? YES NO Emergency Contact Information In the event that you become a tenant of Airdrie Housing, who would you like us to contact in the event of an emergency? Name: Phone number: Relationship:
Affordable Housing Application P a g e 8 o f 16 Household Income Information In the table below, please list the GROSS monthly income amounts you receive from the APPLICABLE income sources listed. Ensure if you list a source of income, that a copy of the deposit or cheque information is included. Employment Income Monthly Income Applicant Household Member #2 Household Member #3 Assured Income for the Severely Handicapped (AISH) Canada Pension Plan Old Age Security Guaranteed Income Supplement Alberta Seniors Benefit Alberta Works Income Support Rental Supplement Programs (please specify) Child Tax Benefit (including Universal Child Tax Credit amount) Child Maintenance Payments/Spousal Support Payments Alberta Family Tax Credit (paid twice per year) GST Rebate (paid four times per year) Other Income (please specify) Total Monthly Income
Affordable Housing Application P a g e 9 o f 16 Residential History Applicants are asked to list previous housing information if they have been at their current address for less than two years. Previous Address: Lived there from until Reason for leaving: Landlord s name: Landlord s phone number: Previous Address: Lived there from until Reason for leaving: Landlord s name: Landlord s phone number: Previous Address: Lived there from until Reason for leaving: Landlord s name: Landlord s phone number: Has anyone named on this application lived in a Calgary Housing subsidized unit? YES NO If yes, please provide the address of the unit, the date when you moved out and the reason for leaving:
Affordable Housing Application Page 10 o f 16 Household Assets and Loan Information Assets not considered for the application include: bursaries or scholarships for current students in the household RESP and RRSP investments (within reasonable limits) personal effects such as clothing and jewelry, trade or business tools needed for employment assets derived from government compensatory packages Assets which are considered include: vehicles stocks, bonds, term deposits, mutual funds, cash business equity property Assets Total Value Income or Interest received in last 12 months Stocks or Bonds Savings Bonds Savings/Chequing Account #1 Savings/Chequing Account #2 Term Deposits Mutual Funds Property (full or part ownership in a house or land) Vehicle (you only need to complete this if there is more than one vehicle in the household) Automatic Withdrawal Information Do you have any loan payments which are automatically withdrawn from your bank account each month? YES (If yes, please describe below) NO Payment/Loan Description Amount of Automatic Withdrawal Date of the month when the payment is withdrawn
Affordable Housing Application Page 11 o f 16 Vehicles Do you OWN a vehicle? YES NO If yes: How many vehicles do you own? Please list the Make, Model and Year of each vehicle: Do you LEASE a vehicle? YES NO If yes: How many vehicles do you lease? Please list the Make, Model and Year of each vehicle: Self-Employment Do you have ownership of a business? YES NO Name of business: Address of business: Please attach the three most recent monthly financial statements. Is there anything else you that you wish Airdrie Housing to know about your situation?
Affordable Housing Application Page 12 o f 16 Employment Verification This document is to be completed by the applicant s employer. (One form per employer, please request additional forms from Airdrie Housing Limited as needed). This form is required to verify that the household income is ongoing, as a pay stub only verifies what has been earned to date. THE EMPLOYER ACKNOWLEDGES THE CONFIDENTIALITY OF THIS DOCUMENT Name Company Company Address Phone Number Date Employment Commenced Gross Earnings (before deductions) $ Yearly $ Monthly $ Biweekly Date the above Earnings Commenced Earnings from Overtime, Bonuses, Commissions etc. which the employee may receive during the year: *********** I HEREBY CERTIFY THE ABOVE INFORMATION AS CORRECT: Employer Name Phone Number (Please print) Employer Signature Date Position/Title
Affordable Housing Application Page 13 o f 16 Budgeting Worksheet This worksheet is intended to assist Airdrie Housing clients to project their monthly budget. Please fill out the following worksheet and return it with your application. Here are some resources that can help 1. Visit www.povertyreduction.ca to ensure you are accessing all the government benefits to which you are eligible. 2. Attend a budgeting workshop. These are offered at Momentum (www.momentum.org or call 403.272.9323) and Community Links (www.nrvcl.ab.ca or call 403.945.3900). 3. Investigate methods for saving money every cent counts! Involve the whole family so each member knows where the money comes from and where it needs to go. 4. Keep track of dates when the bills are due to avoid costly late charges. 5. Download http://alis.alberta.ca/pdf/cshop/stretchyourdollars.pdf for free. Monthly Income what money do you count on each month? Net Income (wages or salary after deductions) Child Tax Benefit Child Support Spousal Support Other regular monthly income, such as CPP benefits, Social Assistance or Employment Insurance GST rebate (four times per year) Alberta Family Tax Credit (two times per year) (A) Total What other income is received during the year? Other (divorce settlement funds, property sale etc.) (B) Total Total Income (A + B) = C: $
Affordable Housing Application Page 14 o f 16 Monthly Expenses Annual Expenses Housing Rent Education School fees Tenant Content Insurance Electricity Heat Water Busing Tuition Books and supplies Special events and trips Phone/Cable/Internet Other Transportation Bus Fare Other Car Loan/Lease Payment Other Car Insurance Gas & Parking per month (E) Total Total Monthly Expenses (D + E) = F Groceries Food Personal hygiene products, etc. What is your financial picture? F C = Medical Prescriptions Other Other Loan Payments Credit Card Payments Other Expenses Clothing Children s Allowances Eating out/coffee Child Support/Spousal Support Life Insurance Medical Insurance Disability Insurance Other expenses (D) Total $ Thank you for completing this budgeting worksheet. Please note that if your expenses are more than your income, Airdrie Housing may not be able to offer you an Affordable Housing Unit as to do so would potentially lock you into a rental payment that you cannot afford. Remember to ask about or investigate other housing options, including: Calgary Housing 403.221.9100 Norfolk Housing 403.270.3062 The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails. William Arthur Ward
Affordable Housing Application Page 15 o f 16 How Airdrie Housing Keeps Information Confidential All information you share with Airdrie Housing Limited is kept confidential within the agency and used for the sole purpose of the administration of programs. Staff members meet on occasion to exchange ideas and suggestions on how to better support the clients we are working with. Airdrie Housing Limited has a duty by law, without notification to disclose confidential information to: a) Children s Services when there is suspected child abuse and/or neglect b) Court Authorities when Community Links staff or records are court ordered or subpoenaed c) Authorities if there is evidence or risk of harm to self or others In instances where collaboration with another service provider is appropriate, we will not seek information from or provide information to any other person without a completed Consent for Release of Information Form. Personal information is collected according to the Freedom of Information and Privacy Act (Section 33 (c)) and is for use by Airdrie Housing Limited and the administration of its programs only. The information is stored in a database and kept on the agency s secure server. Questions about the collection of this information can directed to the Housing Assessment Coordinator at 403-945-3900, #105 104 1 st Ave. N.W., Airdrie, AB T4B 2B8 In accordance with the Freedom of Information Act and Provincial Personal Information Protection Act, clients may request access to their client information. Requests should be made in writing and signed by the person making the request thirty (30) days in advance. Confidentiality Agreement I/We have read the above: Applicant signature: Date: Co-Applicant signature: Date: Witness Name: Witness Signature:
Affordable Housing Application Page 16 o f 16 Consent for Release of Information Please review the Confidentiality Agreement above for information regarding how your personal information is collected and used. In accordance with the Freedom of Information and Protection of Privacy Act section 34 (1) (K) (i) and (ii), I/We give Airdrie Housing Limited staff permission to exchange pertinent information with the agency support workers or other people listed below. I/We understand that Airdrie Housing Limited and the below named persons or agencies will only be exchanging personal information necessary to assist me in obtaining independent living within a Airdrie Housing Limited unit. The release of information is in effect from to (If this portion is left blank, the consent will expire one year from the date this form is signed by the applicant) Current Landlord Person to contact Phone number Previous Landlord Employer or Case Worker Personal Reference Date: Applicant name: Witness name: Applicant signature: Witness signature: Co-Applicant name: Co-Applicant signature: Declaration I/We hereby certify that all statements made in this application are true and I/we agree to provide current and complete income information in whatever form Airdrie Housing Limited requests. It will be the applicant s responsibility to inform Airdrie Housing Limited of any changes to this application within 30 days. Applicant s Signature Date Co- Applicant s Signature Date Witness Name: Witness Signature: