Rental Application Form

By completing and submitting this form electronically, you hereby make application
to rent property from Landlord and agree to allow records checking and credit checking
to be performed.

I am applying for the property located at

Your FULL Name (required)

Date of Birth (required)

Cell Phone # (required)

Other Phone #

Your Email (required)

Co-Applicant Name (required)
enter n/a if not applicable

Co-Applicant Date of Birth (required)
enter n/a if not applicable

Names and ages of all occupants not on this Application (required)
enter n/a if not applicable

Requested move-in date (required)

Please provide Residential History for last 5 Years

1. Current Address (required)

Date Moved In (required)

Reason for Leaving (required)

Rent Amount (required)

Landlord/Agent Name (required)

Landlord/Agent Phone (required)

2. Previous Address (required) enter n/a if not applicable

Date Moved In (required)

Date Moved Out (required)

Reason for Leaving (required)

Rent Amount (required)

Landlord/Agent Name (required)

Landlord/Agent Phone (required)

3. Previous Address (required) enter n/a if not applicable

Date Moved In (required)

Date Moved Out (required)

Reason for Leaving (required)

Rent Amount (required)

Landlord/Agent Name (required)

Landlord/Agent Phone (required)

Please Describe your Credit History:

Have you declared bankruptcy within the past seven (7) years?               YesNo
Have you ever been evicted from a rental residence?                              YesNo
Have you been late paying your rent anytime throughout this past year?  YesNo
Have you ever wilfully or intentionally refused to pay rent when due?       YesNo
Have you ever been late or missed a water bill payment this past year?    YesNo
Have you ever been late or missed a hydro bill payment this past year?    YesNo

Please Provide Employment History

Your Current Employment Status (required)
Full TimePart TimeStudentUnemployed

Company/Employer Name (required)
Date Employment started (required)  
yearly Salary (required) $
Your Supervisors Name (required)
Employer Phone (required)

Previous Employment Information:
Company/Employer Name
Date Employment started  
Date Employment ended  
Yearly Salary $
Your Supervisors Name
Employer Phone

Company/Employer Name (required)
Date Employment started (required)  
Date Employment ended (required)  
Yearly Salary $
Your Supervisors Name (required)
Employer Phone

Company/Employer Name
Date Employment started  
Date Employment ended  
Yearly Salary $
Your Supervisors Name
Employer Phone

Please provide Co-Applicant Employment History

Your Current Employment Status (required)
Full TimePart TimeStudentUnemployed

Company/Employer Name (required)
Date Employment started (required)  
Yearly Salary: $
Your Supervisors Name (required)
Employer Phone (required)

Previous Employment Information:
Company/Employer Name
Date Employment started  
Date Employment ended  
Yearly Salary $
Your Supervisors Name (required)
Employer Phone (required)

Company/Employer Name
Date Employment started  
Date Employment ended  
Yearly Salary $
Your Supervisors Name
Employer Phone

Company/Employer Name
Date Employment started  
Date Employment ended  
Yearly Salary $
Your Supervisors Name
Employer Phone

If Applicant or co-Applicant were employed for less than 18 months:

List Company Name, Supervisor, Phone and Dates in the area below.
If you were a student, list School, Phone, Dates, Contact Name & Type of Program enrolled in

Optionally, if you have other sources of income that you would like us to consider, please list them below.

Source Amount per month
Contact Name Contact Phone

Source Amount per month
Contact Name Contact Phone

Please list references ensuring no duplicated relationships

1. Reference
Name: (required)
Address: (required)
Phone: (required) Relationship

2. Reference
Name: (required)
Address: (required)
Phone: (required) Relationship

3. Reference
Name: (required)
Address: (required)
Phone: (required) Relationship

Additional Information

Please provide any additional information that might help landlord evaluate this application

By checking this check box, I do hereby electronically apply to lease property identified above from landlord for a period of no less than 1 year and agree to pay rent the first day of each month in advance. Furthermore as an inducement to the landlord, I warrant the information and statements submitted above is true and without error.

By clicking this check box, I do authorize an investigation of tenant history, employment, credit history and previous utility on-time payment for the purpose of renting property from landlord.

Conducting any kind of business from within the property is not allowed, by clicking this check box you acknowledge this and accept this.

by clicking this check box, you acknowledge and accept that the first months rent and last months rent along with a damage deposit will be collected prior to moving in.