Reference#

Suite#

Address

Rent
DailyMonthlyYearly

Term
1 year lease2 year lease6 month leaseShort termMonth to Month tenancy

Included in rent

Occupancy desired

Applicant

Last Name

First Name

Middle

Date of Birth

House Phone

Work Phone

Driver Licence

Cell #

Your Email (required)

Currently

Current Address

City

Prov.

From date

To date

Contact

Phone Number

Reason for Moving

Current rent you are paying?

What kind of term were you on?

Previously

Previous Address

City

Prov.

From date

To date

Contact

Phone Number

Reason for Moving

Current rent you are paying?

What kind of term were you on?

Employment

Company

Job

Address

Tel

How Long?

Position

Salary

Contact

Tel #

List all other occupants, including yourself - One per line

Will you purchase tenants insurance while residing in this premise?
Yes No 

Do you have any pets?
Yes No 

Are you bringing any pets to this residence?
Yes No 

If so, list all pets and age:

Do you smoke?
 Yes No

If so, where?
 Inside Outside Both

Have you ever been late with your rent?
 Yes No

If so, Explain

Do you have any bad credit?
 Yes No

If so, Explain

Vehicle

Make

Model

Lic #

Second Car

Make

Model

Lic #

Emergency Contact

Name

Phone #

Relationship #

Second Emergency Contact

Name

Phone #

Relationship #

Consent

I AUTHORIZE THE LANDLORD/AGENT TO OBTAIN INFORMATION/REPORTS/ENQUIRES TO VERIFY THE ABOVE IS TRUE ACCURATE AND COMPLETE BUT LIMITED TO CREDIT REPORTING AGENCIES.
I UNDERSTAND THE ABOVE IS PRIVATE AND WILL NOT BE CIRCULATED. I UNDERSTAND THAT THE ACCEPTANCE OF THIS APPLICATION IS NOT ON A FIRST COME FIRST SERVE BASIS YET BASED SOLELY ON THE LANDLORDS APPROVAL.

WE THE TENANT HAVE PAID AN APPLICATION DEPOSIT OF:
$ (NOT A SECURITY DEPOSIT) AND IF THIS APPLICATION IS NOT ACCEPTED WITHIN 5 BUSINESS DAYS BY THE LANDLORD THE APPLICATION DEPOSIT WILL BE REFUND WITHOUT INTEREST TO THE TENANT WITHIN 7 BUSINESS DAYS, IF THIS APPLICATION IS ACCEPTED BY THE LANDLORD THE APPLICATION DEPOSIT WILL BE CONSIDERED RENT AND WILL BE APPLIED TO THE FIRST MONTHS RENT AND IF THE TENANT DOES NOT ENTER, OR PROCEED WITH THE RESIDENTIAL AGREEMENT WHICH THE TENANT HAS THE OPTION TO VIEW PRIOR TO SENDING IN THIS APPLICATION THE TENANT WILL BE HELD LIABLE FOR PAYMENT OF EQUIVALENT OF ONE MONTHS RENT TO THE LANDLORD PLUS ANY COST ASSOCIATED TO RE RENTING THE PREMISE. A SECURITY DEPOSIT IN THE AMOUNT LISTED ON THE TENANCY AGREEMENT WILL BE REQUIRED PRIOR TO POSSESSION OF THE PREMISE.

Dated

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Trillion RealtyJames ZastePetr VokounRocky Chow

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