Annual Occupancy Declaration

Definitions:

Employee

an individual who is employed or self employed for a minimum average of twenty hours per week, and whose place of business is situated within the boundaries of the Resort Municipality of Whistler.

Retiree

an individual who has ceased active employment but who has been an employee as per the above definition for five of the six years prior to ceasing employment.

Family Member

parent, child, sibling or in-law of the Employee or Retiree.

I / We, the registered owner(s) of the Property, represent to the Whistler Housing Authority the following for the period from January 1st 2009 to December 31st, 2009:

1. Property Information:

   Unit Number
   Street Number
   Street Name

2. Only the following persons have resided at The Property (including suite if applicable):

   Name of all Employees and Retirees

   Dates (From - To)	Name of Employee/Retiree	Name of Employer
   (Add Row)

   How many employees reside in your resident restricted property at any one time?

   Name of additional Family Members

   Dates (From - To)	Name of Family Member	Age (If Dependent)
   (Add Row)

   How many additional family members reside in your resident restricted property at any one time?

3. The Property is (mark one or more):

   Main House	Suite (If Applicable)
   Owner Occupied	Owner Occupied
   Room(s) Rented Monthly Rent:	Rented Monthly Rent:
   Entire Unit Rented Monthly Rent:

4. Contact Information:

   Your Name
   Mailing Address
   State / Province
   Postal Code
   Phone Number
   Email Address

5. Please Enter The Code Below:

   Verification Code: