City Housing Eligibility & Application (Page 7 of 8) in pdf

City Housing Eligibility & Application Page 7

Is there any additional information that would help us to meet the applicant’s needs:

Agency Signature

Date

Disclosure by applicant:

If I

accept a City Housing tenancy and City

Housing have real and justifiable concerns about my tenancy or well-being I give them permission to contact the

following persons.

Case Manager / Key Person

Telephone Day-time

After Hours

And/or

Family Member / Whanau / Supportive Friend

Telephone Day-time

After Hours

Pursuant to Principles 3 & 10 of the Privacy Act 1993

The information is being collected to enable the Council to maintain it’s Rental Housing records.

The intended user and holder of the information is City Housing, Christchurch City Council

You have the right of access to and correction of any personal information held about you by the Council

The personal information is not required by law, however, if refused, the council may decline your application.

Your personal information will not be shared with any units of the council who are not involved in

processing your application or attending to any matters relevant to your tenancy.

City Housing Eligibility & Application Page 7