Are you looking for reliable information about the Ministry of Social Development (MSD) form? If so, then you have come to the right place! This blog post will provide a detailed guide on how to accurately complete and submit an MSD form. We will start by explaining what an MSD form is, why it’s needed, who needs to fill out an MSD form and how to go about submitting one. After that, we’ll provide details on what happens after your submission as well as any potential pitfalls or problems you may run into during the process. By taking all these things into consideration carefully before submitting your application, you can ensure that everything goes through with maximum efficiency – meaning getting the results that are required in no time at all!
| Question | Answer |
|---|---|
| Form Name | Ministry Of Social Development Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | income assistance shelter form, pwd shelter form, shelter verification form, bc social assistance shelter verification form |
SHELTER INFORMATION
(FOR OFFICE USE ONLY) CASE NUMBER
(FOR OFFICE USE ONLY) SR NUMBER
The personal information requested on this form is collected under the authority of and will be used for the purpose of administering the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act. The collection, use and disclosure of personal information is subject to the provisions of the Freedom of Information and Protection of Privacy Act. Any questions about this information should be directed to your local Employment and Assistance Office.
This form is NOT a tenancy agreement. This form should be used ONLY if a tenancy agreement is NOT available. This form is for ministry information only. For information on tenancy agreements and rental housing, see the Residential Tenancy Branch website at http://www.rto.gov.bc.ca. All information provided to the ministry may be verified.
CLIENT INFORMATION
CLIENT LEGAL NAME
BIRTHDATE (YYYY MMM DD)
CURRENT DATE (YYYY MMM DD)
RENTING OR INTENDING TO RENT AT THE FOLLOWING ADDRESS
UNIT # |
STREET ADDRESS |
|
|
CITY / TOWN |
POSTAL CODE |
||
|
|
|
|
|
|
|
|
MAILING ADDRESS (IF DIFFERENT) |
|
|
CURRENT PHONE NUMB R |
|
|||
|
|
|
|
|
|
||
RENTAL START DATE |
IS THE RENTAL UNIT ON RESERVE LAND? |
PHONE NUMBER AFTER MOVE |
|
||||
|
|
YES |
NO |
SAME AS ABOVE, OR: |
|
|
|
|
|
|
|
|
|
|
|
PLEASE COMPLETE SECTION A, B OR C (Please complete one section ON Y):
Section A - Renting a
TOTAL RENT
$
CLIENT'S PORTION OF RENT (IF SHARED)
$
TOTAL # OF PEOP E AT GIVEN ADDRESS
ADULTS CHILDREN
Section B - Room and Board (common areas shared with landlord, meals ARE provided)
AMOUNT PER MONTH
$
IS THE CLIENT OR CLIENT'S SPOUSE RELATED TO THE ERSON(S) PROVIDING ROOM AND BOARD?
YES NO
Section C - Room Only (common areas shared with landlord, meals ARE NOT provided)
AMOUNT PER MONTH
$
TOTAL # OF PEOPLE SHARING ROOM
ADULTS CHILDREN
OTHER COSTS
SECURITY DEPOSIT REQUIRED CLIENT'S PORTION
YES |
NO |
$ |
|
|
|
DOES CLIENT SHARE A KITCHEN OR ARE UTILITIES INCLUDED IN RENT? BATHROOM WITH OWNER?
YES |
NO |
YES |
NO |
To the Client: If any utilities are NOT included, please provide copies of the utility bills to ministry staff when received. The client must provide a rent receipt to the ministry as soon as the first month's rent is paid (unless rent is paid directly to the landlord by the ministry).
LANDLORD INFORM TION
To the Landlord: The ministry may arrange to set up monthly direct deposit payments of the rent directly to the landlord, on the client’s behalf. For more information on how to set up direct deposit, please visit www.sdsi.gov.bc.ca/programs/direct-
NAME OF REGI TERED OWNER
NAME OF LANDLORD OR PROPERTY MANAGER / AGENT (IF DIFFERENT)
ADDRE |
OF LANDLORD |
CURRENT PHONE NUMBER OF LANDLORD |
||
|
AME AS ABOVE, OR PROVIDE ADDRESS BELOW: |
|
|
|
|
|
|
|
|
UNIT # |
|
STREET ADDRESS |
CITY / TOWN |
POSTAL CODE |
|
|
|
|
|
MAILING ADDRESS (IF DIFFERENT)
LANDLORD OR PROPERTY MANAGER'S SIGNATURE
DATE (YYYY MMM DD)
HR3037 (15/09/30) |
ORIGINAL - FILE |
COPY - CLIENT |
|
Security Classification: MEDIUM SENSITIVITY
Page 1 of 1