Application for Housing Grant
SUB-COMMITTEE ON HOUSING
APPLICATION
No. Date 1907
| Surname | Address | Rooms | Rent |
| At present | |||
| April 17thHow long? |
| First Name | Age | Occupation | Earnings Per Week | Physical Condition | |||
| Man | |||||||
| Woman | |||||||
| Children | |||||||
| Others in family | |||
| Name and address of present employer | |||
| How long working for present employer | |||
| Name and address of former employer | |||
| How long working for former employer | |||
| Attach two letters of reference. If possible, one should be from a former landlord to whom you have paid rent for some time. If you are living in a permanent camp, one letter must be from the Camp Commander. | |||
| Description of lot | |||
| What evidence of ownership can you give? | Have you a deed? | ||||||||||||||
| Tax receipt? | Contract for purchase? | ||||||||||||||
| Date when you bought lot | |||||||||||||||
| How much paid? | How much unpaid? | ||||||||||||||
| What monthly installments do you pay? | |||||||||||||||
| Attach plan of contemplated house. | (A drawing prepared by applicant, | ||||||||||||||
| showing floor plan and dimensions will answer) | |||||||||||||||
| Estimated cost of house | Of lumber | ||||||||||||||
| Of hardware | Of labor | ||||||||||||||
| Cost of plumbing and sanitary fittings | Water connections | ||||||||||||||
| Sewer connections | |||||||||||||||
| What amount of the total cost of the house are you able to meet? | |||||||||||||||
| What amount do you ask from the Relief Funds? | |||||||||||||||
| (Sign your name here) | |||||||||||||||
| It is absolutely necessary for you to have a contractor’s or builder’s estimate of the entire cost of the house, specifying in detail the cost of building material and plumbing. | |||||||||||||||
| N. B.—Be sure to return this blank after it is filled out, and use the enclosed addressed envelope. | |||||||||||||||
Above form as illustration