APPLICATION FOR HOUSING GRANT

SUB-COMMITTEE ON HOUSING

APPLICATION

No. Date 1907
SurnameAddressRoomsRent
At present
April 17thHow long?
First NameAgeOccupationEarnings
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 befrom 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 theCamp 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 orbuilder’s estimate
of the entire cost of the house, specifying indetail the cost of building material and
plumbing.
N. B.—Be sure to return this blank after it is filled out, anduse the enclosed
addressed envelope.

Above form as [illustration]