HNHC Tenant Survey

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HNHC Resident Maintenance Request

This form is for Residents of Haldimand Norfolk Housing Corporation and the Housing Providers we
manage (Long Point Area, Dunnville, South & Meltcafe, and Del-Gold Villa Non-Profit Housing
Corporations) to submit maintenance request.

Requests are monitored Monday to Friday between the hours of 8:30 AM to 4:30 PM, excluding
holidays, HNHC will review your request by the end of the next business day.

If this matter requires immediate attention, please call (519)426-7792 / 1-800-265-2819.

Please note staff will not enter if dogs are in unit without Resident.

Please fill up form below. *Required

HNHC Complaint Form

We will do our best to resolve your concerns; however, the HNHC must abide by the landlord and tenant laws of Ontario in its response to tenant issues. If your complaint is regarding another tenant/s, please be advised that we will investigate your concerns and proceed in a manner which respects both the laws of Ontario and the tenant’s rights.

Resident Making the Complaint Here

Name *

(required)

Address *

Telephone Number *

Email *

Date(s) & Time(s) of Incident(s)

Please include all dates and times if there were multiple incidents. If this is a chronic issue, we suggest that you note dates/times of all reoccurances. This information is required should this complain lead to an eviction through the Landlord Tenant Board.

Check One: *

A – Incident involves personal damage to me;
B – Incident involves the disturbance of my reasonable enjoyment of the premises;
C – Other: (explain)

I hereby submit a complaint about the following individual:

If your complaint is not about a specific person, you can skip these fields

Telephone Number

Address

Witness (if any) – Name and Address

Attending Police Officer’s Name

(if applicable)

OPP Incident Report #

Provide a full description including individuals involved & actions taken by you to resolve (attach a 2nd page if needed)

Provide a full description of the complaint or incident. *

I understand that I may be required to testify at a Landlord Tenant Board Hearing in order for this matter to be resolved. I understand that due to confidentiality reasons, and in accordance with the Municipal Freedom of Information and Protection of Privacy Act, the HNHC may not be at liberty to discuss the actions taken as a result of my complaint. I understand that various staff will be consulted in order to resolve my concerns. Personal information on this form is being collected pursuant to the Social Housing Reform Act, 2000, S.O. 2000, c.27, Housing Services Act, 2011, and Residential Tenancies Act, 2006 and will only be used to resolve my complaint.

Signature (type your name) *

I certify that all information in my statement is true and correct to the best of my knowledge.

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