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Rental Application

CENTURY 21 POWER REALTY APPLICATION TO RENT LANDLORDS REFERENCE AND INFORMATION SHEET

Looking to rent in what city?

Applicant's full name(*)

Age(*)

Drivers licence

Applicant's phone number

Cell phone number

Do you have voicemail

Email address

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Currently employed at

Current employer's name

How many months have you been employed there?

Employers phone number

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Former employer

Reason for leaving

Employed from (Month/Year)

Employed to (Month/Year)

Former employer's phone number

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Applicants present address

For how many months

Have you given notice to your current landlord?

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Spouse's full name

Spouse employed by

Spouse's Employers Phone Number

Ages of children

Do you have pets?
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If yes, please list types of pets you have.

Want to pay this amount for rent?
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Number of bedrooms you are looking for?
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Credit reference: (list bank, car loans, & credit cards, etc.)

Credit reference #1

Credit reference #2

Any past payment problems that we might discover?

Personal References:

1. Lawyer

Lawyers phone number

2. Parents

Parent's Phone

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In the event of some emergency that would prevent you from paying rent, please provide the name of at least one person who could be called on for assistance.

Emergency Contact

Emergency contact phone number

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BY SUBMITTING THIS FORM, I VERIFY THAT ALL INFORMATION PROVIDED IS ACCURATE AND TRUE. SUBMISSION OF THIS FORM INDICATES THAT I/WE THE UNDERSIGNED, WARRANT THE TRUTH, COMPLETENESS AND ACCURACY OF THE FORGOING INFORMATION AND HEREBY AUTHROIZE AND CONSENT TO CENTURY 21 POWER REALTY LTD. OBTAINING INFORMATION ABOUT ME/US TO CREDIT BUREAUS AND OTHER PERSONS WITH WHO I/WE HAVE OR PROPOSE TO HAVE FINANCIAL DEALINGS OF IF IT BELIEVES THE DISCLOSURE IS REQUIRED BY LAW. I/WE AGREE THAT INFORMATION SO RECEIVED AND THIS APPLICATION MAY BE RETAINED BY CENTURY 21 POWER REALTY LTD.

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