Rental Application

We sincerely thank you for your application.

Application For Rental Accommodation

Application Date
Property Location

Personal Information

First Name	*
Last Name	*
Date of Birth	*
Last 4 Digits of SIN	*
Marital Status	*
Phone	*
E-Mail	*
Vehicle Kind
Plate Number

Other Occupants

First Name *	Last Name	Relationship	Date of Birth *	Vehicle Kind	Plate Number

Current Residence

Current Address	*
Current Phone	*
Move in Date	*
Current Landlord	*
Landlord Phone	*
Current Rent	*
Reason For Leaving	*

Previous Residence

Previous Address	*
Move In Date	*
Move Out Date	*
Previous Landlord	*
Landlord Phone	*
Previous Rent	*
Reason For Leaving	*

Employment Information

Current Status	*
Current Employer	*
Hire Date	*
Employer Address	*
Employer Phone	*
Position	*

Bank Information

Bank/Credit Union

Emergency Contact Information

Contact Name	*
Relationship	*
Address	*
Phone	*

Additional Information

Do You Have Pets?
(If yes, explain)

AUTHORIZATION: -- Please Read Carefully Before Submitting

I hereby certify that the statements made herein are made voluntarily, are for information purposes only and are complete and accurate to the best of my knowledge and belief. I recognize that submitting false information is grounds for immediate denial of rental accommodations and/or eviction. This application constitutes no obligation on the applicant to accept accommodation, if offered or on this office to supply accommodation.

By submitting this application you authorize Management to communicate by email special offers and promotions, and to verify any references that you have listed and to allow landlords to release information related to your tenancy to Royal LePage Icon Realty for the purpose of processing this application and to perform a credit check.

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