Please contact the office for directions in submitting an application with a damage deposit.
When printing off this form, be sure to set your print margins to 0.75" all around.

DANIEL RENTAL PROPERTIES
100 WALKER AVENUE, SUITE #:109, LOWER SACKVILLE, NS, CANADA, B4C 4B3
telephone: (902) 864-5078;  fax: (902) 865-9234;  internet:  http://drp.mc-daniel.com;  e-mail:  drp@mc-daniel.com

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)