Name *

First Name

Last Name

Mobile *

(###)

###

####

Current Business Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Landlord Name *

First Name

Last Name

Phone

(###)

###

####

Co-Applicant Name

If Applicable

First Name

Last Name

Mobile

(###)

###

####

Contact Name *

First Name

Last Name

Phone *

(###)

###

####

From *

MM

DD

YYYY

To *

MM

DD

YYYY

Contact Name *

First Name

Last Name

Phone *

(###)

###

####

From *

MM

DD

YYYY

To *

MM

DD

YYYY

Declaration *

I [We] hereby apply for rental [lease] of the premises as indicated on this application form. My [our] indication of acceptance below, confirms that I [we] will disclose any pertinent information about me [us]. I [We] give the landlord [landlord's agent, representative, property manager] permission to check my [our] credit history, references and other relevant investigation to determine my rental history, court, financial history and my [our] ability to pay rent and maintain the rental unit and rental premises. I [We] clearly understand and agree as evidenced by my [our] acceptance below that this is an application to rent [lease] and in no way includes an agreement between landlord and tenant to rent [lease]. I [We] understand and agree that a tenancy agreement or lease will be entered into at the discretion of the landlord. In the event that the landlord accepts this [my/our] application I understand that full payment of first month’s rent and a security deposit equal to one month’s rent is required prior to the key of said rental unit [rental premises] be delivered to me [us]. I further understand and agree that in the event that the landlord accepts this [my/our] application, once the landlord accepts, a binding offer to rent [lease] said rental unit [premises] is created and if I withdraw or cancel this [my/our] application any and all deposit paid will not be refunded. Landlord will apply said deposit to re-advertisement cost to find a new tenant, administration cost to process a new tenant's application, and loss any loss of income as a result of such cancellation and all other expenses incurred. If accepted, I agree to sign a lease and or written tenancy agreement. In the event that the landlord does not accept this [my/our] application, I understand that reasons for refusal may not be divulged. I have inspected the rental property and hereby confirm that said rental unit [premises] is of acceptable condition as of the date of this tenant application form.

Accept

Do Not Accept

Name *

First Name

Last Name

Date *

MM

DD

YYYY

Co-Applicant Name

First Name

Last Name

Date

MM

DD

YYYY