Woodhaven Manor

Bedroom(s) Required* Bedroom(s) Required* 1 2

Room Preference (if applicable)

Name*

Mailing address*

Postal Code*

Phone Number*

Email*

Birthdays of Each Applicant* (applicant 1, applicant 2)

Contact Person*

Comments

YOU WILL BE ALLOWED ONLY ONE OPPORTUNITY TO REFUSE AN APARTMENT. UPON SECOND REFUSAL, YOUR APPLICATION WILL BE DISCARDED. I acknowledge that my signature indicates I have been made aware by the Landlord that this apartment complex has a house rule of being smoke-free and a breach of this house rule may result in termination of the tenancy agreement. YOU WILL BE ALLOWED ONLY ONE OPPORTUNITY TO REFUSE AN APARTMENT. UPON SECOND REFUSAL, YOUR APPLICATION WILL BE DISCARDED. I acknowledge that my signature indicates I have been made aware by the Landlord that this apartment complex has a house rule of being smoke-free and a breach of this house rule may result in termination of the tenancy agreement. Signature

Date*

I declare the above information is correct and accurate to the best of my knowledge. I understand that this application does not constitute an obligation to provide me with accommodation. I declare the above information is correct and accurate to the best of my knowledge. I understand that this application does not constitute an obligation to provide me with accommodation. Signature

First and Last Name*

Email*

Address*

Postal Code*

Telephone Number*

Marital Status*

Financial Info: Include ALL sources of income, interest income, private pensions, etc. (Gross monthly income before deductions)

Disclosure of Assets* Disclosure of Assets* *Less than $5,000$5,000 - $10,000$10,000 - $15,000$15,000 - $20,000$20,000 - $25,000$25,000 - $30,000$30,000 - $35,000$35,000 - $40,000Greater than $45,000

Length of time at current address*

Landlord name

How much monthly rent/mortgage do you pay?*

Are utilities included in rent? Are utilities included in rent? Yes No

What is the monthly cost of your utilities? (Heat, hydro, water, parking, cable TV, appliances, other) *

How would you rate your present accommodation How would you rate your present accommodation Good Fair Poor

Comments

Reference 1*

Reference 2*

Do you require a parking space?* Do you require a parking space?* Yes No

I understand that this application does not constitute an agreement on the part of Manitoba Housing or Woodhaven Manor to provide me with accommodation. I acknowledge that this application becomes the property of Woodhaven Manor upon delivery. I further acknowledge the right of Woodhaven Manor at any time prior to execution and delivery to withdraw, revoke, or cancel, without penalty or liability for damages or otherwise, any acceptance or approval of this application previously made or given. I acknowledge that my signature indicates I have been made aware by the Landlord that this apartment complex has a house rule of being smoke-free and a breach of this house rule may result in termination of the tenancy agreement.* I understand that this application does not constitute an agreement on the part of Manitoba Housing or Woodhaven Manor to provide me with accommodation. I acknowledge that this application becomes the property of Woodhaven Manor upon delivery. I further acknowledge the right of Woodhaven Manor at any time prior to execution and delivery to withdraw, revoke, or cancel, without penalty or liability for damages or otherwise, any acceptance or approval of this application previously made or given. I acknowledge that my signature indicates I have been made aware by the Landlord that this apartment complex has a house rule of being smoke-free and a breach of this house rule may result in termination of the tenancy agreement.* I HEREBY AUTHORIZE WOODHAVEN MANOR TO CONDUCT A PERSONAL INVESTIGATION.

Signature*

Date*