Rental Application

RENTAL APPLICATION FORM:

Fill out this application if you are interested in property rentals through Century 21 Amos Realty.
Application for Tenancy
Required fields are marked with a
*Full Name

First NameLast Name
*Birth Date

MonthDayYear
*E-mail
*Phone Number

Area CodePhone Number
*Date Required
*Desired Town
*Rent Range
*Bedrooms Required
*Are You A Smoker
*Present Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
*Current Landlord Name
*Landlord Phone #

Area CodePhone Number
*Can The Landlord Be Contacted
*If no, Please Explain why
*Length Of Time At Current Residence
Reason For Leaving
*Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
*Landlord Name
*Landlord Phone #

Area CodePhone Number
*Can The Landlord Be Contacted?
*If No, Please Explain Why
*Length Of Time At Previous Address
Reason For Leaving
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Previous Landlord Name
Landlord Phone #

Area CodePhone Number
Can The Landlord Be Contacted:
If No, Please Explain Why
Length Of Time At Previous Residence
Reason For Leaving
PROPOSED OCCUPANTS
*Described each person who will occupy the premises
*Do You Have Any Pets?
*If Yes, Please Describe:
PETS: This is inclusive of cats, dogs, hamsters, rodents, turtles, snakes, spiders or fish. Any and all living organisms other than humans. All pets will require a Damage Deposit as per the LTA. This deposit will be equal to one half a month's rent that will be due prior to occupancy.
*Do Your Have Any Water Filled Furniture?
If Yes, Please Descirbe:
EMPLOYMENT / FINANCIAL INFORMATION
Present Occupation
Employer Name
Employment Address
Employer Phone #

Area CodePhone Number
Name Of Supervisor
Length Of Employment
Salary:
Previous Occupation
Employment Address
Employer Name
Employer Phone #

Area CodePhone Number
Name Of Supervisor
Length Of Employment
Gross Income
Per Year/Month/Week
SPOUSE EMPLOYMENT / FINANCIAL HISTORY
Present Occupation
Employer Name
Employer Phone #

Area CodePhone Number
Employer Address
Name Of Supervisor
Length Of Employment
Previous Employer
Employer Name
Employer Address
Phone Number

Area CodePhone Number
Supervisor Name
Length oF Employment
Gross Income
Please Indicate per Year/Month/ Week
EMERGENCY INFORMATION
*In Case Of Emergency Notify
*Phone #

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship
VEHICLE INFORMATION
# Of Vehicles That Will Be On Premises
Vehicle Make
Vehicle Model
Vehicle Year
License Plate #
Vehicle Make
Vehicle Model
Vehicle Year
License Plate #
REFERENCES

(At least 2 required - Landlords, Friends, Co-workers, etc.)
*Full Name

First NameLast Name
*Phone #

Area CodePhone Number
*E-mail
*Relationship To You
*Full Name

First NameLast Name
*Phone #

Area CodePhone Number
*E-mail
*Relationship To You
OTHER INFORMATION
*Have You Ever Been Served An Eviction Notice Or Been Asked To move?
*If Yes, Please Explain Why
*Have You Ever Been Convicted Of A Felony?
*If yes, Please Explain Why
*Why Are You Moving From Your Current Address?
*We may conduct credit and / or criminal background checks. Is there anything negative we will find that you want to comment on?
SURVEY
*How Did You Hear About Us?
If Other, Please Specify:
APPLICANT AUTHORIZATION Applicant represents that all the above statements are true and correct and hereby authorizes landlord/agent to verify the above items including, but not limited to, the obtaining of a credit report and agrees to furnish additional credit references upon request. The tenant also authorizes the "Landlord" "Century 21 Amos Realty & Property Management" to make inquiries with other agencies and or services available to them to confirm the information supplied here in.
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AQUARIUMS: If the tenant wishes to have an aquarium larger than ten (10) gallons, the tenant must carry from year to year a "Personnel Property Tenant Insurance Policy" with a minimum liability of one million dollars ($1,000,000.00) AND must be presented to the property management company prior to occupancy.
FORMS OF ACCEPTABLE PAYMENT OF MONIES TO CENTURY 21 AMOS REALTY:
1) Pre-Authorized Debit 2) E-Transfers *NO CHEQUES ACCEPTED.
I Agree To The Terms & Conditions

YesNo
E-mail
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RENTAL APPLICATION FORM:

Application for Tenancy

Required fields are marked with a

PROPOSED OCCUPANTS

PETS: This is inclusive of cats, dogs, hamsters, rodents, turtles, snakes, spiders or fish. Any and all living organisms other than humans. All pets will require a Damage Deposit as per the LTA. This deposit will be equal to one half a month's rent that will be due prior to occupancy.

EMPLOYMENT / FINANCIAL INFORMATION

SPOUSE EMPLOYMENT / FINANCIAL HISTORY

EMERGENCY INFORMATION

VEHICLE INFORMATION

REFERENCES

OTHER INFORMATION

SURVEY

FORMS OF ACCEPTABLE PAYMENT OF MONIES TO CENTURY 21 AMOS REALTY:

1) Pre-Authorized Debit 2) E-Transfers *NO CHEQUES ACCEPTED.