Housing Rental Application

Cook and Oliphant

This is an Application to rent?
Dates of Tenancy
Your Details*
Name Date of Birth Phone Email
Current Address
Street Address City Province Postal Code
Current of Previous Tenancy
Name of Landlord Landlord Phone Reason For Leaving
Additional Occupants
Name Age
Additional Occupants
Name Age
Additional Occupants
Name Age
Pets
- Yes
- No
Describe
Smoking
- Yes
- No
Describe
Vehicle Information
Make Model Year
References
Name Relationship (previous landlord, employer) Phone
References
Name Relationship (previous landlord, employer) Phone
Yearly Income
Previous Year This Year
Signature (please type name)*
I herby state that the information contained herein is true and I authorize my reference as listed above to release information regarding my employment and/or past/ current tenancies. I also authorize a credit check to be conducted.
Date*