MIX RENTAL APPLICATION Suite NumberDate Unit Is Required# of Occupants In The UnitMonthly RentParking Space #1Car (Make / Year / Plate #)Parking Space #2Car (Make / Year / Plate #)A DEPOSIT CHEQUE PAYABLE TO 345-353 DUCKWORTH STREET DEVELOPMENTS LP IN TRUST FOR (75% OF ONE MONTH’S RENT) MUST BE SUBMITTED ONCE YOUR APPLICATION HAS BEEN APPROVED TO SECURE THE APARTMENT.PERSONAL INFORMATION - APPLICANT #1Name (First / Middle / Last)Phone Number (Day)Phone Number (Evening)Phone Number (Cell)EmailSIN*Date Of BirthCurrent AddressHow Long Have You Been At This Address?Current Monthly RentCurrent Landlord's NameCurrent Landlord's Phone NumberPast AddressHow Long Did You Live At This Address?Monthly RentPast Landlord's NamePast Landlord's Phone NumberEmployment I Am Employed I Am Retired I Am Self Employed Other (If you do not have an employer, please explain your source of income)Current EmployerSupervisor's NameSupervisor's Phone NumberYour Title / OccupationHow Long Have You Been Employed Here?Current Yearly SalaryPast EmployerSupervisor's NameSupervisor's Phone NumberHow Long Were You Employed Here?Personal ReferenceReference's OccupationReference's Phone NumberEmergency Contact NamePhone NumberAlternate Phone NumberRelationship To ApplicantAddressEACH APPLICANT MUST FILL OUT THIS FORM. TO ENSURE A QUICK APPROVAL, PLEASE MAKE SURE INFORMATION IS COMPLETE. *Providing your Social Insurance Number is optional. Please note, however, that most credit reporting agencies use the Social Insurance Number as a unique identifier to ensure proper identification when conducting credit reviews and preparing credit reports. If you do not wish to provide your Social Insurance Number, 345-353 Duckworth Street Developments Limited ability to obtain a timely and accurate credit report may be affected, hence affecting our ability to complete your application.PERSONAL INFORMATION - APPLICANT #2Name (First / Middle / Last)Phone Number (Day)Phone Number (Evening)Phone Number (Cell)EmailDate of BirthCurrent AddressHow Long Have You Been At This Address?Current Monthly RentCurrent Landlord's NameCurrent Landlord's Phone NumberPast AddressHow Long Did You Live At This Address?Monthly RentPast Landlord's NamePast Landlord's Phone NumberEmployment I Am Employed I Am Retired I Am Self Employed Other (If you do not have an employer, please explain your source of income)Current EmployerSupervisor's NameSupervisor's Phone NumberYour Title / OccupationHow Long Have You Been Employed Here?Current Yearly SalaryPast EmployerSupervisor's NameSupervisor's Phone NumberHow Long Were You Employed Here?Personal ReferenceReference's OccupationReference's Reference's Phone NumberEmergency Contact NamePhone NumberAlternate Phone NumberRelationship To ApplicantAddress*Providing your Social Insurance Number is optional. Please note, however, that most credit reporting agencies use the Social Insurance Number as a unique identifier to ensure proper identification when conducting credit reviews and preparing credit reports. If you do not wish to provide your Social Insurance Number, 345-353 Duckworth Street Developments Limited ability to obtain a timely and accurate credit report may be affected, hence affecting our ability to complete your application.I/We understand that Pre-Authorized Payment (PAP) is REQUIRED upon signing of the lease. (initials required)Proof of electricity transfer to tenants’ name must be produced before keys are issued. (initials required)I/We understand that there is to be no smoking on the premises. (initials required)Proof of Tenant Liability Insurance must be produced before keys are issued. (initials required)Should I not sign the lease or accept occupancy on the above stated possession date, you are hereby authorized to rent the premises to someone else and the holding deposit paid herewith shall be retained by 345-353 Duckworth Street Developments Limited as liquidated damages. Upon executing the lease, the holding deposit will be retained as a security deposit which will be refunded at the termination of the lease provided that all covenants of the lease agreement have been adhered to and that the suite is left in a proper state of cleanliness and repair. Please note that 345-353 Duckworth Street Developments Limited has a no cash policy.I/We, 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 associated tenancy issue. (initials required)I/We hereby give permission to 345-353 Duckworth Street Developments Limited to provide contact information to Bell Aliant to assist with telecommunication requirements and to advise of incentives and discounts available to MIX Tenants. (initials required)I hereby offer to lease from the 345-353 Duckworth Street Developments Limited the suite referred to above as the terms stated and if accepted, undertake to execute a lease in the standard form used by 345-353 Duckworth Street Developments Limited for the building. I represent that the information provided in this application is true and correct and authorize you to obtain a credit report.DateApplicant #1Enter Name In Lieu Of SignatureDateApplicant #2Enter Name In Lieu Of SignatureCAPTCHA