Asset Source - Combined for Applicant and Co-Applicant
Bank Account 1
Bank Account 2
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.
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.
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:
Review the Rules and Regulations of the Rented Premises document below, for your reference.
Physician Medical Report
Rules and Regulations of the Rented Premises
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