Property address *(required)

Name of tenants *(required)

Present Address

City

Province

Email *(required)

Phone *(required)

Status of current address *(required)
 Rented Owned


If rented Please fill out this section

Landlord name

Landlord phone number


Your S.I.N. number

Your date of birth (dd/mm/yyyy)*(required)


If you are employed Please fill out this section

Place of employment

Name of manager

Manager phone number

Years of employment

Yearly gross earning

Additional earning


Bank information

Bank name and location

Bank account number


Additional information

Person/s to reside in house

If more than 1 person, Please list below

Others
(e.g. Name/ Relation/ Age) press enter to separate the lines.

If you have any pet/s Please fill out this section

Number of pets

Breed
If more than one separate them (e.g. pet 1/ pet 2/ ...)

If you have any instrument Please fill out this section

What kind of instrument you have?


If you have any guarantor, Please fill out this section

Name

Relation

Phone

Occupation

Salary

Guarantor address

City

Province

Other information
(Education, other source of income)


Terms of agreement

The undersigned hereby confirms and warrants that the above is true and correct and takes notice that you or
your agents may be referring to a consumer report respecting me/us containing personal information and/or credit
information and I/we hereby consent and to the disclosure of such information to you.

Do you accept terms of agreement? *  I ACCEPT

Verification

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