Fe rr rs) MOVING TO A NEW PLACE Home search application form Please write the first or main applicant's surname here Important: Please make sure you vead all the information presented in this document carefully before you complete this form. A. Your details First namejs} ii Key Give any other namejs} Andres you were previously known by Date of birth is “ororEes ES For example 06/12/1968 ‘Contact/correspondence: or safe address (if different from above| Contact telephone numbers(s}Do you experience difficulties gu with reading or writing? What's your gender? Male| what is your religion? Prefer not to-say ‘Muslim Sikh B. Employment information i you are working, please tell us: Yes What de you do? Buddhist Christian Hindu Jewish | = goer, [oad C. Your family or household We mead to know if ether people will be moving with yeu. This will help us ta know what type of home you will need. Please give their details below. no [| yg oe Last name (Caperes. Ibarra: ‘Caceres First name José Nancy Jhoant Date of birth 100370 241200 141106 Gender Male Female Male Relationship Dad Mom Brother to you (wife, son, etc.)english’ works 2.0 ae Cees D. Your present accommodation/circumstances ‘Tick the bax against the property type in which you live of best describes your circumstances. FE Hostal ‘condominium Hotel Bungatow ‘comage Terraced house beaded house Semi-detached house No fixed ais [oa i = E. Your house preferences State your house preferences describing all the characteristics you want your new Fiome to have. House type (apartment, cottage, etc.) Detached house Number of rooms 4 Bedrooms Number of bathrooms [Ss Bsthrooms Which fcor iflacated in a building) Public utilities (gas, water, etc} ee eens Location ing tranquil zone , far rom high traffic. Pricewf rose ae F. Special requirements Write more detailed description of the kind of house you want to have. Like that the new house has a living room, a dining room, a kitchen and a backyard. G. Applicant’s signature ‘ome Kayle Andres Caceres barra a Date 4042015 a