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Rental Application
Rental Application
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Full name
*
Age
Driving license or Passport No.
Phone number
*
Email address
*
Current address
*
Current rent
*
Address of premise to be rented
*
2201- 3102 Windsor Gate, Coquitlam
Upper floor house in Port Coquitlam Port Coquitlam
1407-1182 Westwood Street, Coquitlam
3581 Sheffield Avenue, Coquitlam
308-5005 Ash Street, Vancouver
8860 Sierpina Drive, Richmond
202-19673 Meadow Gardens Way, Pitt Meadows Pitt Meadows
Basement 3053 Plateau Blvd. Coquitlam
G02-3085 Primrose Lane, Coquitlam
3201-1188 Pinetree Way, Coquitlam, B.C. V3B 0K9
2505-823 Carnarvon Street, New Westminster
Basement 1612 Parkway Blvd. Coquitlam
Basement 296 Leroy Street, Coquitlam
Unit 1101-7358 Edmonds Street, Burnaby
Basement 1- 5439 Gilpin Street
Date required
*
Adults
*
0
1
2
3
4
5
6
7
8
9
10
Children
*
0
1
2
3
4
5
6
7
8
9
10
Under 18
Ages of Children
Pets
*
Yes
No
Employer
*
Occupation
*
Annual income
*
Employed since
*
Phone number
Former employer
Phone number
Period
to
Spouse full name
Phone number
Employed by
Annual income
Credit reference
1.
2.
List bank, credit union, charge accounts, or other credit references.
Personal references
*
1.
Phone
2.
Phone
Landlords or employers
Referred to landlord by
I hereby authorize the person or firm to whom this application is submitted to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of a credit account or for any other direct business requirement. This consent is given pursuant to chapter 78, section 12, of the Credit Reporting Act, R.S.B.C. 1979
Submit Application
