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INDEPENDENT LIVING

REGISTRATION FORM

INDEPENDENT SENIORS APARTMENT BUILDING 59+

 

RENTAL APPLICATION

1. Applicant
Please select your choice of apartment building, in order of preference. (Do not select the same building more than once.)
2. Spouse/Co-Applicant
3. Present Accommodation
Note: Average wait times up to 1 year for 1 Bedroom and up to 2 years for 2 Bedroom.

Si prega di tenere a mente che i tempi di attesa sono fino a un anno per un locale con una camera da letto, e fino a due anni per un locale con due camere da letto.
4. Statement of Gross Annual Income and Assets
Note: Your application will be returned to you if a copy of your recent Income Tax Notice of Assessment is not attached.


List all Annual Income and Assets for you and all other persons who will live with you in the Rental Unit.
Employment (from all Sources)
Canada Pension
Old Age Security
Supplements
Foreign Pension
General Welfare
Other Income
4. Statement of Gross Annual Income and Assets - Continued

Asset Source - Combined for Applicant and Co-Applicant


Bank Account 1


Bank Account 2


Interest

Subject to the other terms of this Application, information is to be relied upon by us in any legal proceedings, or must otherwise be produced in accordance with relevant law. Subject to the approval of your application in compliance with all the terms and condition, your name will be placed to our waiting list and we will contact you upon the availability.

APPLICANT'S ACKNOWLEDGEMENT

The undersigned acknowledges that I.C.B.S.A.C. – C.A.B.C. is not a nursing home and that to be accepted as a tenant and to remain a tenant the undersigned must be able to either:  (i) manage on her/his own and be in good health or (ii) make arrangements satisfactory to I.C.B.S.A.C. – C.A.B.C. to receive all appropriate support services from a service agency in the community.  Tenants are responsible to care for their personal needs and if the time should come that any resident:  (i) is not able to care for her/his personal needs, or (ii) has not made arrangements satisfactory to I.C.B.S.A.C. – C.A.B.C. to receive all appropriate support services from a service agency in the community, then it shall be necessary for such resident to find accommodation elsewhere and vacate the premises.

 

INFORMATION CONSENT

The undersigned consents to I.C.B.S.A.C. – C.A.B.C. obtaining such information as may be deemed necessary at any time in connection with the undersigned in respect of her/his application for the above premises being applied for herein and for any renewal or extension thereof.  The undersigned also consents to the disclosure of any information concerning the undersigned and the sharing or exchange of information concerning the undersigned, with and to: (i) any credit reporting agency or to any person to whom the undersigned has or proposed to have financial relations and to I.C.B.S.A.C. – C.A.B.C. obtaining a credit report concerning the undersigned and/or (ii) any physician or other health care professional.  The undersigned agrees to provide to I.C.B.S.A.C. – C.A.B.C. satisfactory evidence of age, health, income and Canadian Residency.  The undersigned further agrees to submit to I.C.B.S.A.C. – C.A.B.C. forthwith, a certificate of health executed by his/her doctor in the form required by I.C.B.S.A.C. – C.A.B.C.

 

ADDITIONAL FORMS

Download, print and have a physician complete the Physician Medical Report, below.  Note: Your application will not be accepted if the Physician Medical Report is not completed and submitted to the Management Office by mail, email, fax or in person.

 

By Mail/In Person:

Email:

Fax:

 

Review the Rules and Regulations of the Rented Premises document below, for your reference.

 

Physician Medical Report

 

Rules and Regulations of the Rented Premises