Rental Application
SUBMIT this form, or download the PDF version here. If you have any questions, email us at info@burkmanagement.com
Please Note: One Application per Adult (18 and over), is required
The information provided on this form is collected under the authority of the Personal Information Protection Act, part 2, section 3(11) and will be used to determine and verify eligibility for rental accommodation and acceptance as a Tenant. If you have any questions, email us at info@burkmanagement.com
Full Name
*
First Name
Last Name
Property Applying For
9908 107Ave-2 bed, Morinville
9908 107Ave- 1 bed, Morinville
17007 95 St NW, Edm
12035 22 Ave SW, Edm
10836 116 St NW, Edm
10511 69 Ave NW, Edm
10445 78 Ave NW, Edm
10208 113 St NW, Edm
44 RiversideDr, StAB
17105 109 St NW, Edm
6214 180 St NW, Edm
14808 125 St NW, Edm
Property Not Listed here
E-mail
Cell/Mobile Number
*
area code + number
HOME Number
area code + HOME number
Emergency Contact
*
First Name
Last Name
Emergency Contact Number
*
area code + number
Birth Date
*
January
February
March
April
May
June
July
August
September
October
November
December
Month
1
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1920
Year
Social Insurance Number
*
Other Adults to Occupy the Premises
Other Adult # 1
First Name
Last Name
Age of Other Adult #1
Other Adult # 2
First Name
Last Name
Age of Other Adult #2
Other Adult # 3
First Name
Last Name
Age of Other Adult #3
All Minors (children age 17 and under) to Occupy the Premises
Minor/Child #1
First Name
Last Name
AGE of Child #1
Minor/Child #2
First Name
Last Name
AGE of Child #2
Minor/Child #3
First Name
Last Name
AGE of Child #3
Minor/Child #4
First Name
Last Name
AGE of Child #4
Employment History
Current or Most Recent Employer
Address of Employer (including City)
Length of current Employment
Gross Monthly Salary
Any Other Income/Source (1)
Income Amount $ (1)
Any Other Income/Source (2)
Income Amount $ (2)
Any Other Income/Source (3)
Income Amount $ (3)
Supervisor Name
First Name
Last Name
Supervisor Phone #
-
Area Code
Phone Number
Previous Employer
Length of previous Employment
Rental History
Present Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long did you live here?
Landlord or Company Name
Landlord Phone #
-
Area Code
Phone Number
Landlord Email
(if available)
Previous Address...
Previous Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long did you live here?
Landlord or Company Name
Landlord Phone #
-
Area Code
Phone Number
Landlord Email
(if available)
Pets and Parking
Pets (please describe)
How many Vehicles will be parked on premises
Make/Model/Year/License #
Final Submit
Terms
I hereby certify that all statements made in this application are true and I hereby authorize Burk Management and Realty Inc. to conduct a personal investigation/credit check and to contact any person identified in this Rental Application. The failure to obtain an accurate and satisfactory credit report may, in the sole discretion of Burk Management and Realty Inc., adversely affect my application. I hereby acknowledge that there are no pets allowed on these premises without written authorization from Burk Management and Realty Inc. In order for Burk Management and Realty Inc., to comply with federal and/or provincial privacy legislation, I understand that all personal information collected from me may be collected, used and disclosed by Burk Management & Realty Inc. for the purpose of my application assessment and debt collection, to comply with applicable law. I hereby acknowledge that by checking the box below, I fully understand and agree to the terms ad conditions stated by Burk Management & Realty Inc. and give our permission to perform and adhere to the stated disclosure.
*
I Agree
Signature
Clear
Submit Application
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