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I make the following in representations and warranties knowing that they will be relied on by those agencies supplying socially assisted housing in Grey County to assess my qualifications for rental accommodation and establish rent:

  1. The information given on this form is accurate and complete
  2. I understand that it is my responsibility to inform Grey County Housing within 30 days, of any change to the information on this application. Failure to do so may result in this application being cancelled.
  3. I understand that if subsidized rental accommodation is provided to me, it is my responsibility to inform the Landlord within 30 days of any changes in my family composition or financial position. Failure to do so may result in my subsidy being withdrawn and I may be prohibited from reapplying for subsidized housing for a minimum period of two years under the Housing Services Act 2011.
  4. I understand that if rental accommodation is provided to me, that accommodation is to be occupied only by me and those members of my family approved by the Landlord and listed on the lease.
  5. I understand that this application is not an agreement on the part of Grey County or their agents to provide me with accommodation.

I give consent and authorization to Grey County Housing and other agencies supplying socially assisted housing in Grey County:

  1. To make any inquiries that they deem necessary to verify the information given on this application form and I authorize any person, corporation or social agency having knowledge of any such required information to release that information to Grey County Housing and/or the Socially Assisted Housing Providers in Grey County.
  2. To disclose any information given on this application form and any attachments to the social services offices, other municipal service managers or district social services administration boards and housing providers without further notice to me, if the information is necessary for the purpose of making decisions or verifying eligibility for assistance under the Housing Services Act 2011, the Ontario Works Act 1997, the Ontario Disability Support Program Act 1997 or the Day Nurseries Act 2011.
  3. To disclose any information given on this application form and any attachments to the Government of Canada, a department, ministry or agency of it, without further notice to me if information is necessary for the purpose of administering or enforcing the Income Tax Act (Canada) or the Immigration Act.

Personal information contained in this form or in attachments is collected by Grey County Housing pursuant to the Freedom of Information and Protection of Privacy Act (R.S.O. 1990cF31.) or the Municipal Freedom of Information and Protection of Privacy Act (R.S.O. 1990cM56). Nothing in this form is intended to infringe upon the rights guaranteed in the Ontario Human Rights Code.

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