Eng- 三人單位申請(甲類) Category A – Application for 3-person Unit Important Notes Interested applicant should read carefully the Application Guide and Checklist of Supporting Documents. Please prepare all supporting documents for uploading onto the online application system. Declarations and Undertakings I agree and understand the application process, application materials, selection criteria, etc. of the project. I and/or family members undertake to abide by the policies and arrangements of application and allocation of the housing of the project that are or will be implemented. YOT reserves the right to the final decision on the arrangement of the housing. From the date of submitting my/our application form to the effective date of the Tenancy Agreement of Yan Oi House Transitional Housing Project, I and/or family members 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 covered in the relevant terms of the Application Guide. I and/or family members agree that YOT may, in processing my/our application, collect my/our personal data from other 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 abovementioned organizations and/or any other third party. I and/or family members authorize these organizations and/or any other third party possessing my/our personal data to furnish YOT with my/our personal data for the vetting of my/our application. I and/or family members agree that YOT may disclose, verify and/or transfer personal data in the application form and all provided relevant documents to relevant departments, organizations or participating parties in the process, assessment and investigation of applications. All personal data will be processed in accordance with the policies of YOT from time to time and the Personal Data (Privacy) Ordinance. I and/or family members agree that the information provided in this Application Form may be used by YOT for statistical survey or research. I declare that the information provided by me and/or the applicant on behalf of myself in this application form and other information submitted/to be submitted for this scheme is true and correct. I understand that if I make false statements or cover up information knowingly or willfully, or any other means to mislead YOT, I may immediately lose eligibility for application and bear any loss caused, and may be required to immediately cease to use the housing unit under the project if required by YOT. I understand that YOT reserves the right of final decision to determine whether the information I provide is misleading. I and/or family members understand and agree to vacate the unit when the Tenancy Agreement is terminated or when the Project ends or after I/we have been allocated a public rental housing unit. I and/or family members understand that I/we must return vacant possession of the transitional housing unit to YOT within 3 months from the commencement of new tenancy and give no less than 1 month’s written notice to YOT. I understand and agree that except for me and/or my family members listed in this application, the third parties cannot exercise any power under the Contracts (Third Party Rights) Ordinance (Chapter 623) to enforce the terms and conditions of this application and/or the relevant agreements, or enjoy the benefits under the terms and conditions. (Please “✔” as appropriate) Declarations and Undertakings * I have read, understood and agreed to comply with each of the above declarations and undertakings, and affirm that the information provided is correct. In the event of any changes, I will notify the Yan Oi House Transitional Housing Project immediately. Part I - Eligibility Criteria Eligibility Criteria * Category A: Individuals/family who have been on the application waiting list for public rental housing (PRH) for not less than 3 years.# Category B:Currently living in dismal and inadequate housing conditions.@ For Category B applicants, please click here to visit the Category B application form. # The applicant must have an acknowledgement card (The Blue Card) issued by the Hong Kong Housing Authority (HA) and the applicant’s household information must tally with that contained in the relevant PRH application (including but not limited to family size, income and asset value). The PRH application must have been registered for more than 3 years. @ The applicant and his/her family members must meet HA’s prevailing policies and eligibility criteria for applying for PRH (including but not limited to family size, income and asset value). Each applicant (including his/her family members) shall submit only ONE application by one of the application methods. YOT reserves the right to cancel ALL duplicate applications. Part II - Unit Types Unit Types * 3-person unit Part III - Personal Particulars – Applicant Chinese Name English Name * Required to be same with Identity document. Sex * Male Female Contact Phone Number * Correspondence Address * Date of Birth * Type of Hong Kong Identity Option: * Hong Kong Permanent Identity Card Hong Kong Identity Card Hong Kong Birth Certificate (For minors aged below 11) HKSAR Re-entry Permit Document of Identity for Visa Purposes Permit for Proceeding to Hong Kong and Macao (One-way Permit) Passport Identity Document No. * Copy of the identification documents * Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Proof of address Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Marital Status * Married Single Divorced Widowed Separated Working Status * Full-time Part-time Self-employed Retired Unemployed Student Homemaker Occupation / grade Average monthly income in the past 6 months * $ Income Proof (in the past 3 months) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (2) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (3) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Wheelchair-needed due to Chronic illness / disability * Yes No Receiving any social service? If yes, please list out the type of service(s): family support service, children and youth service, community service or elderly day care service, etc. * YesYes No Current Monthly Subsidies Received by the Family from the Government * Comprehensive Social Security Assistance Normal / Higher Disability Allowance Old Age Allowance (Fruit Money) Normal/ Higher Old Age Living Allowance Working Family Allowance Half/ Full School Textbook Assistance Others (Please specify)Others (Please specify) No/ Not applicable Total monthly subsidies received by the family from the Government (in the past 6 months) * $ Proof of income from government’s social security scheme Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Proof of income from government’s social security scheme (2) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Proof of income from government’s social security scheme (3) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Is there any family member with pregnancy of 16 weeks or more? * Yes (Please specify the no. of week of pregnancy)Yes (Please specify the no. of week of pregnancy) No Which of the following ways can you receive the Acknowledgement of Application? (You may choose more than one) * WhatsApp SMS None of the above If applicable, please state the phone number for receiving WhatsApp/ SMS notification How did you learn about Yan Oi House? (You may choose more than one) * Yan Oi Tong Website Service centres of Yan Oi Tong Referral from other organizations Physical Newspaper Online News sites Renting websites Facebook Leaflet Radio Television YouTube Relatives or friends Others(Please specify)Others(Please specify) Part IV - Public Rental Housing Waiting Status Have you already applied public rental housing (PRH) * Yes No Proof of public housing application * Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. PRH number * PRH application date * PRH application district * New Territories (Tuen Mun, Yuen Long, Tin Shui Wai, Sheung Shui, Fanling, Tai Po) Urban (Hong Kong Island and Kowloon) Extended Urban (Tung Chung, Shatin, Ma On Shan,Tseung Kwan O, Tsuen Wan, Kwai Chung, Tsing Yi) Islands (excluding Tung Chung) Part V - Personal Particulars – Family member(s) Family Member(1) Chinese Name English Name * Required to be same with Identity document. Sex * Male Female Date of Birth * Type of Hong Kong Identity Option: * Hong Kong Permanent Identity Card Hong Kong Identity Card Hong Kong Birth Certificate (For minors aged below 11) HKSAR Re-entry Permit Document of Identity for Visa Purposes Permit for Proceeding to Hong Kong and Macao (One-way Permit) Passport Identity Document No. * Copy of the identification documents * Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Marital Status * Married Single Divorced Widowed Separated Relationship with applicant * Spouse Parent Child Grand-child Grand-parent Brother/Sister Other Copy of relationship proof Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Working Status * Full-time Part-time Self-employed Retired Unemployed Student Homemaker Occupation / grade Average monthly income in the past 6 months * $ Income Proof (in the past 3 months) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (2) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (3) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Wheelchair-needed due to Chronic illness / disability * Yes No Receiving any social service? If yes, please list out the type of service(s): family support service, children and youth service, community service or elderly day care service, etc. * Yes No Child with special educational need. If yes, please specify * YesYes No Family Member(2) Chinese Name English Name * Required to be same with Identity document. Sex * Male Female Date of Birth * Type of Hong Kong Identity Documents Option: * Hong Kong Permanent Identity Card Hong Kong Identity Card Hong Kong Birth Certificate (For minors aged below 11) HKSAR Re-entry Permit Document of Identity for Visa Purposes Permit for Proceeding to Hong Kong and Macao (One-way Permit) Passport Identity Document No. * Copy of the identification documents * Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Proof of Address Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Marital Status * Married Single Divorced Widowed Separated Relationship with applicant * Spouse Parent Child Grand-child Grand-parent Brother/Sister Other Copy of relationship proof Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Working Status * Full-time Part-time Self-employed Retired Unemployed Student Homemaker Occupation / grade Average monthly income in the past 6 months * $ Income Proof (in the past 3 months) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (2) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Income Proof (in the past 3 months) (3) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Wheelchair-needed due to Chronic illness / disability * Yes No Receiving any social service? If yes, please list out the type of service(s): family support service, children and youth service, community service or elderly day care service, etc. * YesYes No Child with special educational need. If yes, please specify * YesYes No Part VI - Income & Net Asset Value Total Monthly Household Income (in the past 6 months) * $ Total family monthly Subsidies from Government * $ Net Asset Value of the Household (including bank deposits, stock, land, landed properties (domestic properties, shops, parking spaces, etc.), vehicles, taxi/public light bus licenses, investments(saving funds, funds, shares, etc.), Business undertakings (whether with business registration or not), Loan to other, etc.) (Hong Kong/Mainland China/Oversea) * $ Household Net Asset Value Proof (within past 3 months) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Household Net Asset Value Proof (within past 3 months) (2) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Household Net Asset Value Proof (within past 3 months) (3) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Household Net Asset Value Proof (within past 3 months) (4) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Household Net Asset Value Proof (within past 3 months) (5) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Household Net Asset Value Proof (within past 3 months) (6) Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Part VII - Current Living Conditions Have you ever benefited from any forms of social housing projects? * Yes No Type of residential housing currently in occupancy * Subdivided units (separate toilet) Roof-top units Cubicles Living in other person’s unit Bed space apartment Temporary housing Homeless Squatter Others Average monthly rent in the last three months (excluding utility bills) * $ Proof of Rent Drop a file here or click to upload Choose File Maximum upload size: 10MB Maximum upload file size: 10MB / PDF or Image (jpg/png/gif) only. Unit size (if applicable) ft Number of years living in the current unit month Part VIII - Transferal of personal data and consent (Please “✔” as appropriate) Transferal of personal data and consent I and/or family members agree that if the application is not admitted, all information on application form can be transferred to other organizations launching Social Housing scheme. Corresponding staff is allowed to contact me considering other transitional social housing flat. If you are human, leave this field blank. Submit