Internal use Date of submission: Application No.: Modular Social Housing of Cheung Sha Wan TENACITY RESIDENCE - Application Form

Notes

Applicants are required to understand the eligibility, process and evaluation criteria for the scheme and to complete this application form in block letter by using a black or blue pen. If you have any questions, please contact social workers of Society for Community Organization.
Applicants are required to complete all the information listed in this application form and to provide the relevant supporting documents and statements, otherwise the application form will be returned and the registration may be delayed.
SoCO will inform eligible applicants via SMS/Phone Call to provide an application number necessary, SoCO will draw lots to decide the interview list. SoCO will contact listed applicants by phone according to the assigned order and arrange them for interviews. For applicants who do not receive any notice within 9 months, will be treated as an unsuccessful application. SoCO retains the final right on the allocation of housing.
SoCO reserves the rights of final decision on housing allocation.
Deadline: 15th November 2021 5:30pm (Subject to the postmark date, received time in SoCO’s email record and receive time for application)
Tentative Schedule for Move in: Q1, 2022.The flat in-take of this project may be postponed due to construction delays.

- Step 1 of 7

Part 1 Information of the Applicant

Name of applicant *

Phone no. (Home) *

If not, please fill in the usual contact number

Mobile *

Total area of current flat (Square Feet) *

Address *

Type of Current Flat *

Sub-Divided Unit
Partitioned Apartments
Bedspace
Permanent Flat
Rooftop Unit/Industrial Building and other type of illegal construction
Hostel/Other/Transitional Housing(Venue)

Hostel/Other/Transitional Housing(Venue) *

Average monthly rent in the past 6 months (Utilities Fees Excluded) (HK$) *

Period stayed in current flat (years) *

Application Number for Public Rental Housing : Format:G/U ( ) *

Application date for Public Rental Housing (YYYY/MM) *

Part 2 Personal Data

Number of family members *

One
Two
Four
Five
Six

Single Parent Family *

Applicant

Gender *

Date of Birth (DD/MM/YYYY) *

Marital Status

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Family Member 1

Name in Chinese *

Name in English *

Gender *

Date of Birth (DD/MM/YYYY) *

Identity Document No. *

Relationship with Applicant *

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Any Special Educational Need?

Family Member 2

Name in Chinese *

Name in English *

Date of Birth (DD/MM/YYYY) *

Gender *

Identity Document No. *

Relationship with Applicant *

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Any Special Educational Need?

Family Member 3

Name in Chinese *

Name in English *

Gender *

Date of Birth (DD/MM/YYYY) *

Identity Document No. *

Relationship with Applicant *

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Any Special Educational Need?

Family Member 4

Name in Chinese *

Name in English *

Gender *

Date of Birth (DD/MM/YYYY) *

Identity Document No. *

Relationship with Applicant *

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Any Special Educational Need?

Family Member 5

Name in Chinese *

Name in English *

Gender *

Date of Birth (DD/MM/YYYY) *

Identity Document No. *

Relationship with Applicant *

Marital Status *

Unmarried
Married
Divorced
Widowed
Separated

Chronic illness /Disability(please specify)

Any Special Educational Need?

Part 3 Income & Net Asset Value (in Hong Kong dollars)

#Note 1：Income includes income from employment and other income (including salary, double pay, allowance, year-end bonus/commissions, business or investment profit, alimony, subsidy from relatives and friends, interest earned from savings and shares, rent income, pension, gratuity); excluding MPF contributions, government funding, charity donation and Community Care Fund)

Applicant

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Family Member 1

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Family Member 2

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Family Member 3

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Family Member 4

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Family Member 5

Working Status *

Full-time
Part-time
Unemployed
Retired
Housewife
Studying
Prepare to study

Occupation *

Personal Average Monthly Income in the Past 6 Months (HKD) *

＃Note 1

Household Average Monthly Income in the past 6 months (HKD) *

Part 3 Income & Net Asset Value (Continue)

# Note 2 Family Asset includes land, property (residential units, commercial units, parking spaces), vehicles, taxi/car licenses, investments (saving insurance policies, funds, shares), business and loan to others

Total Subsidy from Government’s Scheme in the past 6 months

Comprehensive Social Security Assistance (CSSA) Scheme
Social Security Allowance (SSA) Scheme
School Textbook Assistance Scheme / Student Financial Assistance
Old Age Living Allowance
Low-income Working Family Allowance (LIFA)
The three-year Cash Allowance Trial Scheme (CATS)
Others

Household Average Monthly Income in the past 6 months (HKD) *

Household Net Asset Value(Supporting documents required ) *

Format: Name of Family Member , Type of Asset, Settlement Date(YYYY/MM/DD)，Value (HKD)
#Note 2

Total Net Asset (HKD) *

Supporting Documents Upload

Files Upload

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Part 5 Declaration of the Applicant and Family Members

1. I/We have read carefully and understood all the application procedures, guideline and criteria before completing the Application Form. I/We undertake to comply with the relevant requirements/arrangements contained therein, as well as all application/allocation policies and arrangements as may be imposed from time to time. SoCO shall have the final decision on housing allocation. *

Agree

2. Apart from this application, I/we have not applied for / currently living any other social housing scheme organized by Hong Kong Council of Social Service (HKCSS) or other non-government organizations. *

Agree

3. As at the date of completing my/our Application Form, I/we have not owned, co-owned, entered into any agreement to purchase or held more than 50% of shares in a company which owns (directly or through its subsidiary) any domestic property in Hong Kong; *

Agree

4. I/We agree that SoCO may, in processing my/our application, collect my/our personal data from relevant government departments, public/private organizations (such as but not limited to financial institutions and banks), and/or any other third party (such as but not limited to employers) possessing my/our personal data for verification and confirmation of my/our eligibility. Whilst the collection of information is in progress, the personal data contained therein may be disclosed to the above mentioned organizations and/or any other third party. In this connection, I/we authorize these organizations and/or any other third party possessing my/our personal data to furnish SoCO with my/our personal data for the vetting of my/our application. *

Agree

5. I/We agree that SoCO may, in handling, processing and/or investigating on my/our application, disclose, verify and/or transfer my/our personal data in this Application Form and all relevant documents to relevant departments, organizations and/or cooperating entities. All personal data will be handled in accordance with the policies adopted by SoCO from time to time and the Personal Data (Privacy) Ordinance (Cap. 486). *

Agree

6. I/We agree that the personal data in this Application Form can be used for statistical survey or research to serve the purposes of doing statistics and researches, including but not limited to understanding the effectiveness of the assistance provided to beneficiaries under the Programme and the living conditions of the beneficiaries, on condition that the resulting statistics and research findings will not be shown in a way that data subjects or any of the persons involved that can be identified; and to fulfil the purposes required, authorized or permitted by law *

Agree

7. I/We declare that all the above furnished in this Application Form and all information submitted/ to be submitted are true and correct. I understand that if I/we knowingly make any false statement or furnish any false information or mislead SoCO in any other ways, I/we may be prosecuted and immediately lose my/our eligibility for application or may be required to immediately cease to use the flat. I/We understand that any person who intentionally provides false information or omits information to fraudulently obtain eligibility for the project commits an offence. *

Agree

8. I understand and agree that nothing in this Application Form and/or relevant agreement(s) confers or purports to confer on any third party any benefit or any right to enforce any term of this Application Form and/or relevant agreement(s) pursuant to the Contracts (Rights of Third Parties) Ordinance (Cap. 623). *

Agree

9. I/We understand and agree that I/we need to move out of the flat at the end of this project or upon receiving an offer of public housing (60 days after signing the tenure). *

Agree

10. I/We agree that if this application could not offer me/ my family a unit, SoCO may transfer my/our personal data in this Application Form and all relevant documents to relevant non-profit making organizations and/or cooperating entities to apply for other transitional social housing scheme (if any) *

Agree

11. I/We agree that Transport and Housing Bureau may, in processing my/our application, collect my/our personal data from relevant government departments, public/private organizations (such as but not limited to financial institutions and banks), and/or any other third party (such as but not limited to employers) possessing my/our personal data for verification and confirmation of my/our eligibility. *

Agree

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Internal use Date of submission: Application No.: Modular Social Housing of Cheung Sha Wan TENACITY RESIDENCE - Application Form

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Notes

Part 1 Information of the Applicant

Part 2 Personal Data

Applicant

Family Member 1

Family Member 2

Family Member 3

Family Member 4

Family Member 5

Part 3 Income & Net Asset Value (in Hong Kong dollars)

Applicant

Family Member 1

Family Member 2

Family Member 3

Family Member 4

Family Member 5

Part 3 Income & Net Asset Value (Continue)

Supporting Documents Upload

Part 5 Declaration of the Applicant and Family Members

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Main Office:

Kweilin Street Office

Hai Tan Street Office

Community Health Center (Tsuen Wan)

Prior Social Housing Limited

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