Primary Applicant's Full Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

####

Desired Move-In Date *

MM

DD

YYYY

Do you smoke (includes vaping, bongs and e-cigarettes)? *

Yes

No

Employment Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Supervisor's Contact Phone

(###)

###

####

Secondary Applicant's Full Name (If Applicable)

First Name

Last Name

Employment Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Supervisor's Contact Phone

(###)

###

####

Applicant 1's Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant 1's Previous Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant 1's Reference's Name

First Name

Last Name

Applicant 1's Reference's Phone *

(###)

###

####

Applicant 1's Reference's Name *

First Name

Last Name

Applicant 1's Reference's Phone *

(###)

###

####

Applicant 1's Reference's Name *

First Name

Last Name

Applicant 1's Reference's Phone *

(###)

###

####

Applicant 2's Reference's Name

First Name

Last Name

Applicant 2's Reference's Phone

(###)

###

####

Applicant 2's Reference's Name

First Name

Last Name

Applicant 2's Reference's Phone

(###)

###

####

Applicant 2's Reference's Name

First Name

Last Name

Applicant 2's Reference's Phone

(###)

###

####

Have you or any of the applicant's listed ever been evicted for any reason? If yes, provide a brief description of circumstances involving the eviction. *

Yes

No

Have you or any of the applicants listed ever been convicted for criminal activity? *

Yes

No

Have you or any of the applicants listed filed for bankruptcy in the last 10 years? *

Yes

No

Are you willing to give permission to allow for a credit check for all applicant's included on this application? *

Yes

No

Are you willing to give permission to allow for a police records check for all applicant's on this application? *

Yes

No

Note: Answering this question does not constitute consent for the landlord to do so. Further documentation will be provided in the event one is required. I hereby certify that payment of rent on required days leaves me in a comfortable financial situation. *

Yes

No

I certify that all this information herein is accurate and truthful to the best of my knowledge and I authorize the Landlord to verify my employment information and references. I also understand that all information contained is private and confidential, and will remain so, in compliance with the Canadian Privacy Policy Act. *Please type your full name below if you agree to the terms above. * *

First Name

Last Name