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Residential Application Form

Location Applying for:  
1. Tenant Information
Full Name: Drivers License No:
Address: Social Insurance No:
City: Date of Birth:
Province: Home Phone Number:
Postal Code: Cell Phone Number:
Email Address: Fax Number:
 
Present Employer: Supervisor's Name:
Address: Work Phone No:
Gross Monthly Salary: Additional Income
(specify source):
 
Previous Employer: Supervisor's Name:
Address: Work Phone No:
 
2. Rental Information
Address: Landlord Name:
City: Landlord Phone No:
Province: Length of Tenancy:
Postal Code: Reason for leaving:
 
Address: Landlord Name:
City: Landlord Phone No:
Province: Length of Tenancy:
Postal Code: Reason for leaving:
 
Full Names of all individuals (including children) who will be occupying the premises:
Will you be having Pets (Specify Age/Neutered or Fixed/Type):
Have you ever been evicted, sued for nonpayment of rent, or breached a lease (if so, please explain)?
Do you smoke? yes no
Are you a student? yes no
Have you ever been convicted of a crime? yes no
 
3. References (The folllowing should not be related to you in any way or friends)
Name: Ph: Relationship:
Name: Ph: Relationship:
Name: Ph: Relationship:
 

I certify that the above information is true and complete. I authorize the verification of this information through checking the above references. I also authorize Coldwell Banker Horizon Realty to obtain a credit report through their business affiliate Mortgage Alliance Homeline Mortgage for purposes related to this application.

 
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