#RTB – 17
Learn more about fee waivers online at: www.gov.bc.ca/landlordtenant/fees#Waiver
Your Application for Dispute Resolution is not considered to have been made until your application has
been submitted and either the fee has been paid or all documents for a fee waiver have been
submitted.
APPLICANT INFORMATION (the person applying for fee waiver)
HOUSEHOLD SIZE
What is the total number of household members?
• Tenants: Your household includes all tenants on the tenancy agreement and any family members or
dependants of those tenants living in the rental unit or site. Unrelated individuals who are not on the
tenancy agreement do not count as part of your household.
• Landlords: Your household includes you and all family members or dependents living in your
residence.
HOUSEHOLD INCOME
What is the total monthly income before deductions of all household members counted above?
PROOF OF INCOME (the Residential Tenancy Branch may ask for additional information or material)
Please check the box(es) and attach copies of the documents that you are providing with this application.
Income Assistance statement Employment Insurance Benefits statement Pension statement(s)
Recent pay stub(s) from employer(s) Bank statements for two most recent months Scholarship statement(s)
Other:
Your personal information is collected under section 26 (a) and (c) of the Freedom of Information and Protection of Privacy Act for the
purpose of administering the Residential Tenancy Act and Manufactured Home Park Tenancy Act. If you have any questions regarding the
collection of your personal information, please contact an information officer by calling 604-660-1020 in Greater Vancouver; 250-387-1602
in Victoria; or 1-800-665-8779 elsewhere in B.C.
Description 1 $
Description 2 $
Description 3 $
Information officer
Cashier transaction No.
Cashier's initials
Applicant's
Signature: Date:
day month year
FOR MORE INFORMATION
RTB website: www.gov.bc.ca/landlordtenant
Public Information Lines 1-800-665-8779 (toll-free) Greater Vancouver 604-660-1020 Victoria 250-387-1602