Application

Eligibility Checklist

Please read the following very carefully. If you answer YES to all of the following questions, you are eligible to make an application for affordable housing with Dartmouth Housing.

Housing Application Form

1. APPLICANT 1 PERSONAL DETAILS

Salutation

APPLICANT 2 PERSONAL DETAILS

Salutation

2. CURRENT HOUSING INFORMATION

Have you received an eviction notice?
Are you in a month to month or fixed term lease?
Have you ever been a tenant in Public, non-profit, or cooperative housing?
How did you hear about Dartmouth Housing?
Do you owe money for past tenancy with any landlord?

3. HOUSING NEEDS

Unit Size
Do you or any other applicant have a vehicle?
Do you or any other applicant have a pet?
Do you or any other applicant require accessibility modifications?
Do you expect the number of people living with you to change in the next 12 months? (e.g. pregnancy, family joining, family leaving, child in care, etc.)

4. INCOME & ASSETS

For all household members 18 years of age or older please provide the most current CRA Notice of Assessment. For each applicant 18 years or older please provide monthly income amounts before deductions for the following categories:

Applicant 1

Income Categories $ / Month

Applicant 2

Income Categories $ / Month

Applicant 3

Income Categories $ / Month

Applicant 4

Income Categories $ / Month

5. HOUSEHOLD COMPOSITION

List yourself on line 1 then all persons who will be living in the unit.

Do They Live Full-Time with You Now?
Do They Live Full-Time with You Now?
Do They Live Full-Time with You Now?
Do They Live Full-Time with You Now?
Do They Live Full-Time with You Now?
Do They Live Full-Time with You Now?

CONSENT & DECLARATION

Please read carefully and tick each consent box:

Consent 1
Consent 2
Consent 3
Consent 4
Consent 5