Rental Assistance Program Application Form
Applicant Information
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Name
Prefix
First Name
Middle Name
Last Name
Social Insurance #
Email
Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address for Mailing
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is residential address different from mailing address?
Yes
No
Residential Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Alternative Contact Name
First Name
Last Name
Alternative Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Bank Information
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Transit #
Bank #
Account #
Bank Stamp
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Household & Residency Information
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People living with you
Address(es) you have lived for the last 1 year
Rent Information
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Monthly Rent $
What your rent include(s) (heat, etc)
Asset & Property Information
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Please write all the assets you and/or your spouse held.
Rows
Name of person who owns the asset
Bank or financial institution
Value ($)
All Bank Accounts (negative and positive)
Term Deposits
Bonds, Stocks, Shares
Trust Funds
Other Assets including Cash
Please list all the property you or/and your spouse held.
Income Information
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Do you or your spouse working?
Yes
No
If no, Have you (or your spouse) earned income from employment income in the last 12 months?
Yes
No
If yes, Please select the last day of working?
 -
Month
 -
Day
Year
Date
Please upload your Record of Employment (ROE)
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Please list all current income source(s)
Declaration
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I, the applicant, agree with the following statements
I declare this is my application form and I fill it out as the best of my knowledge.
All the information I write here to get Rental Assistance Program.
Date
 -
Month
 -
Day
Year
Date
Signature of Applicant
Signature of Spouse (If applicable)
Please upload related documents
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Submit
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