DRP - application form

Daniel
Rental Properties

...providing Property Management and Leasing Services in Halifax, Dartmouth, Bedford and Lower Sackville

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please fill out the application form and submit

Application instructions:

make your selection -

personal info -

roommates info -

children or friends
staying with you?

where are you
living now?

where were you living prior to your present address -

an emergency contact not with you -

current employment information; if unemployed, indicate source of income -

examples: loans, credit cards, open accounts -

office use only -

checking this box is equivalent to signing this application -

please fill out and click the submit button - or - select the printable format and mail in.
( section in red is for office use only )

BUILDING: APARTMENT #: SIZE:
DESIRED DATE OF OCCUPANCY: ASAP or insert DATE:

Name in Full: Date of Birth: SIN:
Telephone Number: h) w) Email Address:

Roommate: Date of Birth: SIN:
Telephone Number: h) w) Email Address:

Additional Persons Name: Date of Birth:
Date of Birth:

Present Address: Phone # (res.):
house or apt.; rent or own; rental rate: ; how long: ; lease term:
Reason for Leaving:
Present Landlord's Name: Telephone Number:

Previous Address:
Previous Landlord's Name: Telephone Number:

Next of Kin (not with you): ; Relationship:
Address: Phone #:

Car make & model: ; year: ; plate number: ; province:
Bank: ; branch: ; account type: ; account #:

Employment
SELF: Occupation: Employer: Address: Phone Number: ; How Long: Yearly Income: Previous Employer: Phone Number:	ROOMMATE: Occupation: Employer: Address: Phone Number: ; How Long: Yearly Income: Previous Employer: Phone Number:
Credit References
Self: Company: Address: Account Number:	Roommate: Company: Address: Account Number:

I/we represent that the information provided in this application is true and correct. The undersigned hereby gives authorization to conduct a personal investigation & by my signature accepts as notice in writing of, and authorizes the obtaining of any information required related to this application from any source to which it may apply, and each such source is hereby authorized to provide with such information. If the offer is declined, the total amount given, without interest, will be returned. Should I/we not accept occupancy on the above possession date, you are hereby authorized to rent these premises to someone else and one month’s rent paid herewith shall be retained as liquidated damages for expense in reserving the apartment and processing the application.

Rent: $per month. Security Deposit (in advance): $, date: ; cash; cheque #:

______________________________________ Signature ___________________ _____________________ Signature _______________ Date Signed

_____ _____ (INITIALS REQUIRED)
YES, I HAVE RECEIVED A COPY OF THE RESIDENTIAL TENANCY ACT AND SCHEDULE ‘C’ (HOUSE RULES)

YES - I have read the terms and conditions of this application and have verified all the information is true.

If after you click 'submit' you get an error page, please click back, print off the form, and mail in your application.