Family Housing Application

Thank you for your inquiry regarding Community Housing through Lloydminster Region Housing Group. Please be advised there is a NO PETS policy in all units managed by the LRHG.

The application is very comprehensive so please take the time to read each and every question and answer all that pertain to you and your household.

A reference form must be completed by your current landlord or previous landlord.

In order to process your application for housing we will require, for EACH adult member of the household, any and all of the following documents that would concern your situation.

A signed report from your employer for EACH working member in your household, stating the GROSS rate of pay, hours per week, and total earnings for the past 12 months. Tips or gratuities, alimony or maintenance, commissions and interest are also considered income and must be reported.

If you, OR ANY member of the household are receiving Employment Insurance, Workers Compensation, Social Services or a Pension, copies of the Stubs must be provided.

Verification of Provincial Training Allowance, student loans, bursaries, and/or Scholarships obtained over the last 12 months and the commencement and completion dates of the educational program must be provided.

The most recent Income Tax Return or Notice of Assessment for EACH adult in the household.

When you have gathered all the necessary information, submit the application online, and return remaining documents to our office. Your completed application will be processed as soon as possible and you will be contacted when we are able to offer you accommodation.

Direct any inquiries to our office at 780-875-9131.

DISCLAIMER FOR FORMS CONTAINING PERSONAL INFORMATION ON MANAGEMENT BODY TENANTS

Information on this form is being collected under the Authority of Ministerial Order

No. H:032/99 issued under the Alberta Housing Act (RSA 1994/A-30.1).

It will be used to enable staff of the LLOYDMINSTER REGION HOUSING GROUP to provide support services to tenants residing in Housing Units operated by the LLOYDMINSTER REGION HOUSING GROUP.  It is protected from public disclosure by the provisions of the Freedom of Information And Protection of Privacy Act (RSA 1995/F-18.5).  If you have any questions about the collection of this personal information, please call (780)875-9131 between the hours of 8:30 a.m. and 4:30 p.m. Monday through Friday for clarification.

    Application for Accommodation - Community Housing (Confidential)

    PLEASE READ CAREFULLY AND ANSWER ALL QUESTIONS COMPLETELY.

    I understand that this application does not constitute an agreement on the part of the Lloydminster Region Housing Group or it's agents to provide me with rental accommodation.

    I further acknowledge the right of Lloydminster Region Housing Group or it's agents at any time prior to the execution and delivery to me of a lease hereby applied for, to withdraw, revoke or cancel, without any penalty or liability for damages or otherwise, any acceptance or approval of this application previously make or given.

    I hereby authorize the Lloydminster Region Housing Group or it's agents to investigate any or all of the statements made herein, being fully aware that discover of any false statement shall cancel any further consideration of my application.

    I further agree that I am obligated to advise the Lloydminster Region Housing Group or its agents, in writing, of any changes in family composition, gross family income, assets, employment or change of address, should they occur.

    I ALSO AGREE THAT THE INFORMATION PROVIDED BY ME PERTAINS TO ALL PERSONS NAMED WITHIN THIS APPLICATION.

    I/we do solemnly declare as follows:

    1. That I/we am/are the applicants named in the said application.
    2. That the statements made by me/us in the said application are, to the best of my/our knowledge, information and belief, full and true in all respects.

    MarriedWidowedSingleDivorcedSeparatedCommon-law
    List all persons, INCLUDING YOURSELF, who will be living with you should your application be approved.
    NoYes
    YesNo
    OwnRent
    HouseTownhouseApartmentRooming HouseMotel/HotelOther
    NoYes
    NoYes
    NoYes
    NoYes