Closing Costs Support Program for Modest Income Households

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Personal information on this form is collected under section 32(1)(g) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c.F-15-01, and will be used for assessing your application under the Closing Costs Support Program. If you have any questions about this collection of personal information, you may contact PEI Housing Corporation, 11 Kent Street, 2nd Floor Jones Building, Charlottetown, PE C1A 7M8, 902-368-5770, housing@gov.pe.ca.

Identification

Enter information for the primary contact of the household in the fields below, full legal name (including middle name in the middle initial field). The program officer will communicate with this person.

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Marital Status

Date of Birth

Is there a co-applicant?

Co-Applicant Information

Enter the co-applicant's full legal name (middle name in the middle initial field).