Rental Application

1045 Whitney Midland

* Before starting application please read all questions to prepare your information as this form does not save until submitted

The Landlord Acknowledges The Confidentiality Of This Document.

Applicant Information

Full Name *

Email *

Cell Phone *

Date of birth *

Drivers license # *

SIN # *

Emergency Contact Information

Emergency contact's full name *

Emergency contact's phone *

Emergency Contact's Address *

Emergency contact's relationship to you *

Present Address Information

Present landlord's full name *

Present landlord's phone *

Your present address *

Present Rent Amount *

Move in and move out date at present address *

Have you notified your landlord that you are leaving? *

Reason for leaving present address *

Additional Information

Have you ever been evicted or asked by a landlord or their agent to leave a rented premises? *

Previous Landlord Information

(Required if residing at present address for less than 2 years)

Previous landlord's full name

Previous landlord's phone

Previous address

Previous Rent Amount

Reasons for leaving previous address

Present Employment Information

Present employer *

Position/occupation *

Date started employment with present employer *

Supervisor's full name *

Supervisor's phone *

Place of employment address *

Monthly income before taxes *

Previous Employment Information

(Required if present employment is less than 2 years)

Previous employer

Previous position/occupation

Date started employment with previous employer

Reason for leaving previous employment

Previous supervisor's full name

Previous supervisor's phone

Previous place of employment address

Previous monthly income before taxes

Personal Reference #1 (friend or co-worker only )

Name

Relationship to you

How long have you known them?

Phone #

Personal Reference #2 (friend or co-worker only )

Name

Relationship to you

How long have you known them?

Phone #

I/We, the undersigned, warrant the truth, completeness and accuracy of the foregoing information and hereby authorize the landlord obtaining further information about me/us and to check the information that has been given by me/us. The landlord may also disclose information about me/us to credit bureaus, other persons with whom I/we have or propose to have financial dealings, my/our employer, and previous landlords, for the purpose of checking and verifying my/our employment information, rental history and credit history, in order to approve my/our tenancy. The landlord may disclose information about me/us if it believes the disclosure is required by law. I/We agree that the information so received and this application may be retained by the landlord.

Signature of Applicant *

Clear

Date of Signature *