Rental Application Form

Name(Required)

Date of Birth *(Required)

Phone(Required)

Email(Required)

Untitled

Date

Reason for leaving

Name of landlord

Landlord Phone

Additional Occupants:

List(Required)

Name *

Age *

Desired Move-In Date(Required)

Desired Rent

Desired Lease Duration (Option)

Pets?

Pet? *(Required)

Yes

Pets Describe

Smoking? *

Smoking?(Required)

Yes

Smoking Descript

Employment Status & Income Verification:

Occupation(Required)

Wage(Required)

Company(Required)

Other income description (Disability, Income Assistance, Saving, etc.)(Required)

How long have you worked at this company(Required)

Vehicle Information:

Vehicle information

Make

Model

Year

Have you ever been evicted as a tenant? *(Required)

Yes

Have you ever been convicted of a criminal offence? *(Required)

Yes

Do you insure your belongings? *(Required)

Yes

References:

References

Name *

Phone

Relationship to you

Terms and Conditions:

This is to advise that I the applicant give the Agent to whom my application has been submitted, permission to obtain a consumer credit report, to conduct a criminal record search, an eviction search and to make any other inquiries as deemed necessary in determining eligibility for tenancy and assessing credit worthiness. This document is an offer to rent subject to the Landlords approval based on the information supplied.

TENANCY WILL BE DENIED IF you misrepresent any information on the application. If misrepresentations are found after the rental agreement is signed, your rental agreement will be terminated.