Application To Rent Landlord's Reference and Information Sheet

Personal Information

Applicant's Legal Name:

Phone:

Address:

City:

Postal Code:

Social Insurance Number:

Birthdate:

Employment Information

Applicant Employer Name:

Address:

Phone:

How Long:

Apartment Occupants Second adult or co-signer must fill out separate application and sign tenancy agreement

# of Adults

# of Children

Ages of Children

Pets?

Yes

What kind of Pets

Smoker?

Yes

Desired Property

145 Louth St., St. Catharines

155 Louth St., St. Catharines

299 Glendale Ave., St. Catharines

Date premises required:

Current Landlord Information

Landlord Name:

Date moved in:

Landlord's Phone:

Reason for Leaving:

Previous Landlord Information

Previous Landlord:

Date moved in:

Landlord's Phone:

Reason for Leaving:

Emergency Contact

In case of Emergency please notify:

Relationship:

Phone:

Please check agreement here I hereby authorize the person or firm to whom this application is submitted to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of a credit account or for other direct business requirement.

Date Signed: