Watermill Ridge
30 Fairfax Drive Halifax NS, B3M 1R7
Jim Murwin
Phone: (902) 443-2606
Fax: (902) 457-0212
RENTAL APPLICATION
Building & Apt. # ___________________
Monthly Rent ___________________
Possession Date ___________________
PERSONAL INFORMATION
Name in Full____________________________________ SIN#_______________________________
Date of Birth___________________ Home Phone______________ Work Phone________________
Name of Co-Applicant____________________________ SIN#_______________________________
Date of Birth ___________________ Home Phone______________ Work Phone_______________
RENTAL HISTORY/REFERENCES
Present Address_____________________________ Reason for Leaving ____________________
How long there?_______________________ Landlord's Name _____________________________
Landlord's Address _________________________ Landlord's Telephone __________________
Previous Address_____________________________ Reason for Leaving ___________________
How long there?_______________________ Landlord's Name _____________________________
Landlord's Address _________________________ Landlord's Telephone __________________
OCCUPANTS
List below the names and ages of ALL persons who will occupy theis apartment.
Name in Full Date of Birth
1. _________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
SOURCE OF INCOME
Occupation _____________________________ Present Annual Income _____________________
Name of Employer _______________________ Telephone ___________ How Long There? _____
Previous Employer ______________________ Telephone ___________ How Long There? _____
Co-applicant
Occupation _____________________________ Present Annual Income _____________________
Name of Employer _______________________ Telephone ___________ How Long There? _____
CREDIT INFORMATION
Name of Bank ___________________________ Branch ______________ Account No.__________
Credit Cards/Charge Accounts (list min. of two) ____________________________________
Monthly payments/liabilities _______________________________________________________
PERSONAL REFERENCES
List below two personal references, along with their address, telephone no. and
occupation:
Name Address Telephone Occupation
1. ________________________________________________________________________________
2. ________________________________________________________________________________
VEHICLE INFORMATION:
Master License # License Plate # Car Make and Year
Applicant _____________________________________________________________________
Co-Applicant _____________________________________________________________________
Emergency: Incase of emergency, please notify:
Name Address Telephone Relationship
1. ________________________________________________________________________________
2. ________________________________________________________________________________
I hereby offer to lease from ______________________ the apartment referred to above
and if accepted undertake to execute a lease in the standard form used by the
Landlord for the building. I represent that tile information provided in this
Application is true and correct and authorize you to obtain a credit report. I
enclose herewith the total sum of __________, being a holding deposit (security
deposit following acceptance of Offer), for the apartment noted above. If the Offer
is declined, the total amount without interest will be refunded. Should I not sign
the lease or accept occupancy on the above-noted possession date, I accept
responsibility for payment of the first month's rent; you are hereby authorized to
rent the premises to someone else; and the holding deposit paid herewith shall be
retained by the Landlord as liquidated damages for the Landlord's expense in
reserving the suite. I acknowledge receipt of a copy of the Residential Tenancies
Act. Should this Offer be accepted, I agree to pay rent by providing a series of
post-dated cheques for the lease term.
DATE: ______________ APPLICANT: ________________________________