Rental Application

Residential
Form 410 for use in the Province of Ontario

l/We hereby make application to ...........................................................................................................................................................................

107 Oakes Cres, Guelph, ON N1E 0J5
1st
from the..............................day September
of.............................................. 23
20............at 2800
a monthly rental of $.........................................................................
1st
to become due and payable in advance on the........................................day of each and every month during my tenancy.
1. Name..................................................................................
Adesh Singla 18 sep 2000
Date of birth................................ SIN No. (Optional)..........................................
S4492-01000-00918
Drivers License No......................................................... Exec. Admin
Occupation................................................................................................................
2. Name..................................................................................
Vijay Kumar Date of birth................................ SIN No. (Optional)..........................................
Business
Drivers License No......................................................... Occupation................................................................................................................
3. Other Occupants: Name................................................................................... Relationship.............................................. Age..................
Name................................................................................... Relationship.............................................. Age..................
Name................................................................................... Relationship.............................................. Age..................
Do you have any pets?........................ If so, describe........................................................................................................................................
Moving to Guleph
Why are you vacating your present place of residence?.......................................................................................................................................
LAST TWO PLACES OF RESIDENCE
15 Northwood Dr, Brampton, On, L6X2L3
Address................................................................................................. 49 sand cherry cresc, Brampton, On,L6R3B1
Address...............................................................................................
............................................................................................................ ...........................................................................................................
1st march
From................................................ 30 august
To................................................. 1st september 2022
From................................................ 1st march 2023
To................................................
Michael Nikhil
Name of Landlord.................................................................................. Name of Landlord.................................................................................
226
Telephone: (..............). 9985649
........................................................................... 647 ...........................................................................
Telephone: (..............). 8229537
PRESENT EMPLOYMENT PRIOR EMPLOYMENT
Mauser Packaging
Employer............................................................................................... I..........................................................................................................
Metro north
80 stafford dr, brampton, ON
Business address.................................................................................... I..........................................................................................................
5 Marconi Crt, Bolton, ON
5198528094
Business telephone.................................................................................. I..........................................................................................................
5198528094
Exec. Admin
Position held.......................................................................................... I..........................................................................................................
Office Admin
6 Months
Length of employment............................................................................. I..........................................................................................................
6 Months
Barry
Name of supervisor................................................................................ I..........................................................................................................
Doug
$60K + $150K (Household Income)
Current salary range: Monthly $..............................................................
SPOUSE’S PRESENT EMPLOYMENT PRIOR EMPLOYMENT
Employer............................................................................................... I..........................................................................................................
Business address.................................................................................... I..........................................................................................................
Business telephone.................................................................................. I..........................................................................................................
Position held.......................................................................................... I..........................................................................................................
Length of employment............................................................................. I..........................................................................................................
Name of supervisor................................................................................ I..........................................................................................................
Current salary range: Monthly $..............................................................
Name of Bank.......................................................... Branch.................................. Address..............................................................................................
Chequing Account #..................................................................................... Savings Account #........................................................................................
FINANCIAL OBLIGATIONS
Payments to...................................................................................................................................................................... Amount: $...................................
Payments to...................................................................................................................................................................... Amount: $...................................
PERSONAL REFERENCES
Abhishek
Name...................................................................... 85 seaside circle, Brampton, On
Address..............................................................................................................................................
905 9665049
Telephone: (..............).......................................... 3 Yrs
Length of Acquaintance................................... business
Occupation.........................................................................
Zalak
Name...................................................................... 85 seaside circle, Brampton, On
Address..............................................................................................................................................
905 9237820
Telephone: (..............).......................................... 3 Yrs
Length of Acquaintance................................... business
Occupation.........................................................................
AUTOMOBILE(S)
Honda
Make.......................................................... Accord
Model............................................... 2022
Year............................. Licence No.........................................................
Make.......................................................... Model............................................... Year............................. Licence No.........................................................
The Applicant consents to the collection, use and disclosure of the Applicant’s personal information by the Landlord and/or agent of the Landlord, from time to
time, for the purpose of determining the creditworthiness of the Applicant for the leasing, selling or financing of the premises or the real property, or making such
other use of the personal information as the Landlord and/or agent of the Landlord deems appropriate.
The Applicant represents that all statements made above are true and correct. The Applicant is hereby notified that a consumer report containing
credit and/or personal information may be referred to in connection with this rental. The Applicant authorizes the verification of the information
contained in this application and information obtained from personal references. This application is not a Rental or Lease Agreement. In the event that this
application is not accepted, any deposit submitted by the Applicant shall be returned.

7 August 2023 7 August 2023

Signature of Applicant ...............................................................................................................................................................................................................
Date Signature of Applicant Date
519 8528094
Telephone: (............)....................................................................................
226 3857413
Telephone: (............)....................................................................................
The trademarks REALTOR®, REALTORS® and the REALTOR® logo are controlled by The Canadian Real Estate Association CREA) and identify real estate professionals who are
members of CREA. Used under license.

Form 410 Page 1 of 1

© 2015, Ontario Real Estate Association (“OREA”). All rights reserved. This form was developed by OREA for the use and reproduction of its members and licensees only. Any other use or
reproduction is prohibited except with prior written consent of OREA. Do not alter when printing or reproducing the standard pre-set portion. OREA bears no liability for your use of this form. Revised 2009