APPLICATION FOR PENSIONER HOUSING - Waitomo District Council

APPLICATION FOR PENSIONER HOUSINGOCCUPANCY CRITERIA – HOUSING FOR THE ELDERLY1. Applicants must be 60 years of age or over.2. Applicants must not be property owners.3. Total income per annum must not exceed $18,000 single or $23,000 married.4. Total savings must not exceed $18,000 single and $23,000 married.5. Rentals shall not exceed 20% of tenant’s gross benefit.IMPORTANT INFORMATION• Payments are to be made by direct credit.• Waitomo District residents will get priority when pensioner flat vacancies occur.• Waitomo District Council have the right to refuse this tenancy application. If requested,applicant is to provide proof of age (i.e. passport, drivers licence etc).• There will be a 7 day assessment period to review this tenancy application.• RENT & BOND• Council requires two weeks rent is paid in advance together with the bond. The bond istwo weeks rent.PENSIONER FLAT DESCRIPTION(S)TYPE OF FLAT DESCRIPTION RENT PER WEEK(Please note these prices aresubject to change)Bedsit Bedroom in lounge $57.50Single Room Bedroom separate to lounge $63.50Flats 17, 18, 19 & 20Bedroom separate to lounge.Larger then single room flats.$70.0026425:400/315:CGP1

Full Name(s):APPLICATION FORM – PLEASE COMPLETEDate of Birth:State whether married, single, widower, widow, divorced or separated:Address of Property where you are presently residing:Are you occupying rental premises at present?Yes / NoHow long have you resided in your present dwelling?Annual Income of Applicant:Signature(s) Applicant(s):Are you or your wife/husband or any member of your household the owner of a houseproperty? Yes / NoIf yes - location of the house:Who occupies the house?If the house is in the same town as that in which you are applying for a pensioner flat pleasestate the reason why you are not occupying the house yourself:Are you a New Zealand Citizen: Yes / NoHow long have you lived in Te Kuiti?Please provide:1. Two written references.2. Two credit references (For example your latest phone and power account)3. Contact name and phone number of your present landlord (will be contacted if you are offered apensioner flat tenancy)4. Contact name and phone number of one refereeSignature:Date:Phone Number:OFFICE USEDate Received:26425:400/315:CGP2