MIX RENTAL APPLICATION Suite Number Date Unit Is Required # of Occupants In The Unit Monthly Rent Storage Rent Parking Space #1 Car (Make / Year / Plate #) Parking Space #2 Car (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 FOR THIS APPLICATION TO BE REVIEWED.PERSONAL INFORMATION - APPLICANT #1Name (First / Middle / Last) Phone Number (Day) Phone Number (Evening) Phone Number (Cell) Email SIN* Date Of Birth Current Address How Long Have You Been At This Address? Current Monthly Rent Current Landlord's Name Current Landlord's Phone Number Past Address How Long Did You Live At This Address? Monthly Rent Past Landlord's Name Past Landlord's Phone Number Employment 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 Employer Supervisor's Name Supervisor's Phone Number Your Title / Occupation How Long Have You Been Employed Here? Current Yearly Salary Past Employer Supervisor's Name Supervisor's Phone Number How Long Were You Employed Here? Personal Reference Reference's Occupation Reference's Phone Number Emergency Contact Name Phone Number Alternate Phone Number Relationship To Applicant Address EACH APPLICANT MUST SUBMIT A SEPARATE 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) Email SIN* Date of Birth Current Address How Long Have You Been At This Address? Current Monthly Rent Current Landlord's Name Current Landlord's Phone Number Past Address How Long Did You Live At This Address? Monthly Rent Past Landlord's Name Past Landlord's Phone Number Employment 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 Employer Supervisor's Name Supervisor's Phone Number Your Title / Occupation How Long Have You Been Employed Here? Current Yearly Salary Past Employer Supervisor's Name Supervisor's Phone Number How Long Were You Employed Here? Personal Reference Reference's Occupation Reference's Reference's Phone Number Emergency Contact Name Phone Number Alternate Phone Number Relationship To Applicant Address *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) I/We enclose herewith the total sum (entered amount) being a holding deposit for the above-named suite. If the offer is declined, the total amount without interest will be returned. 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.Date Applicant #1 Enter Name In Lieu Of SignatureDate Applicant #2 Enter Name In Lieu Of SignatureCAPTCHA
