Name *

First Name

Last Name

Phone *

(###)

###

####

Best Day to Meet or Call

Let me know whats the best time to reach you

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

I declare that the information provided in this application is true, complete and accurate. I authorize the landlord and/or its agents or representatives to whom this application is submitted to: (a) contact any and all persons named in this application and I consent to all such persons providing any information requested by the landlord in regards to this application; (b) perform any credit, background, reference and/or criminal checks to verify the accuracy of the information in this application and otherwise fully consider assess my rental application; and (c) collect, use and disclose my personal information for any purposes relating to this application or any ensuing rental. I certify I have never been evicted from a rental property and I have not filed for bankruptcy within the past 5 years. I understand that the landlord has full and absolute discretion to reject my rental application if I have provided any false information or if it acquires information which in its sole determination reflects unfavourably on my application. *

By checking this box, the undersigned agree to the above terms.