The Willow District

The Willow District
Email: leasing@thewillowdistrict.ca Tel: (902) 499-2295
APPLICATION TO RENT
Each individual occupant who will be responsible for rent must complete a separate application form. Please complete all sections.
Suite Type Applying For:
Is there a specific suite you would like to apply for? If so, please enter the suite number below:
PERSONAL INFORMATION
Full Name:

First NameMiddle InitialLast Name
Home Phone #:
Format: (000) 000-0000.
Cell Phone #:
Format: (000) 000-0000.
Work Phone #:
Format: (000) 000-0000.
Email:
example@example.com
Date of Birth:

MonthDayYear
Date
Marital Status:
Other Residents (Including Children)
1. Name:
Age:
Relationship to Primary Applicant:
2. Name:
Age:
Relationship to Primary Applicant:
3. Name
Age
Relationship to Primary Applicant

RESIDENTIAL HISTORY
Present Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long there:
Rent amount:
Landlord Name:
Phone #:
Format: (000) 000-0000.
Reason for leaving:
Previous Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long there:
Rent amount:
Landlord Name:
Phone #:
Format: (000) 000-0000.
Reason for leaving:

EMPLOYMENT HISTORY
Employment Status:
Employer:
Current or Previous:
Length of Employment:
Employer Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor/Caseworker:
Phone #:
Format: (000) 000-0000.
Income:

REFERENCES & OTHER INFORMATION
Professional Reference (Must not be family or friend)
1. Name:
Phone #:
Format: (000) 000-0000.
2. Name:
Phone #:
Format: (000) 000-0000.
Do you have any Pets?:
If yes, what kind and how many?:
Size/weight:

VEHICLES
1. Make & Model
License Plate Number
Year
Colour
Province
2. Make & Model
License Plate Number
Year
Colour
Province

EMERGENCY CONTACT

Someone not residing with you
Emergency Contact Name:
Emergency Contact Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Phone #:
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
OTHER INFORMATION
I hereby certify that the above information is true and complete and that I have not withheld any information relevant to this application. If accepted, I/we undertake to execute a yearly lease in the approved standard form of the province. If, after being notified of acceptance, I cancel this agreement to occupy, the security deposit is forfeited as liquidated damages and not as a penalty. It is the responsibility of the tenant to insure his/her unit and its contents. It is also understood that the property management and/or owner reserve the right to reject this application. I have read and understand these conditions. I hereby give permission to the Landlord or their Agent(s) to obtain at any time a consumer/credit report about me, to contact previous landlords to obtain information about my previous tenancies, to contact agencies that provide landlord information, to contact my references, and to take any other reasonable steps necessary to assess this Rental Application, or for any renewal or extension of my tenancy, or pursue any future outstanding debt. The landlord requires a Pre-Authorized Debit Agreement in the amount of the monthly rent and extra charges (where applicable), plus the security deposit prior to signing the lease. Note: Upon execution of the lease and occupancy of the premises by the tenant, the deposit shall become the Security Deposit.
Applicant's signature
Date

MonthDayYear
Date
Should be Empty:

The Willow District

APPLICATION TO RENT

PERSONAL INFORMATION

Other Residents (Including Children)

RESIDENTIAL HISTORY

EMPLOYMENT HISTORY

REFERENCES & OTHER INFORMATION

Professional Reference (Must not be family or friend)

VEHICLES

EMERGENCY CONTACT

OTHER INFORMATION