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Peterborough Rent Supplement Annual Review Form

Please fill out the information below and upload documents for all household members who are over 17 years of age who are not enrolled in full-time studies.

Please attach the following documents for all household members who are 17 years of age or older and not enrolled in full-time studies

  • Government ID
  • Most recent lease/rental agreement or Notice of rental increase
  • Most recent Utility bills (if paid by tenant)
  • Proof of net income (notice of assessment for most recent filing year or most recent 90-day bank statement) 

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

I have truthfully completed this form and understand that misleading information could cause my rent supplement to be terminated.

Consent to the Collection and Sharing Personal Information  

This information about you is being collected to determine if you are eligible to receive a rent supplement and for your continued participation in the Rent Supplement program.  

The information will be shared with Peterborough Social Services staff, contracted third-party companies for the purpose of processes payments, your landlord, other staff who may work at your landlord's organization.  

Social Services staff will speak to your landlord about your rent supplement to ensure payments are received. This information will be used to issue a payment to your landlord and support you in remaining stably housed.  

A third-party company is contracted to issue payments on behalf of Peterborough Social Services. The third-party will speak to Peterborough Social Services and your landlord about you and your rent supplement. The third-party will only receive the information submitted in this application, which they need in order to issue rent supplement payments.  

Non-identifying data about people who receive rent supplements may be shared with the Government of Canada and the Government of Ontario to support the continued investment in housing and homelessness programs.  

At any time, you can request a list of the personal information that has been collected about you, with whom it has been shared, and what it is used for. 

Notice with Respect to the Collection of Personal Information 

Personal information contained in this form or any additional attachments are collected in accordance with Section 8 of the Municipal Act for the purpose of determining initial and ongoing eligibility for the City of Peterborough Rent Supplement Program funding and will also be de-identified and aggregated for statistical and program planning purposes. Any questions regarding the collection or release of this information should be directed to: Housing Services, City of Peterborough, 178 Charlotte Street PO Box 4138 Peterborough, ON  K9J 8S1 or by calling 705-748-8830.  

By signing below, I/we attest that I/we have read the entire consent and notice of collection to them and that I/we agree. I/we provide informed consent for the rent supplement program. 

Important Note - Ensure all names and signatures are required for all household members 17 years of age and older. 


Thank You

Select the 'Submit' button below to complete this form. Staff will follow up if additional information is required.