Rental Application

PERSONAL INFORMATION:
Date: Monday November 25/2024

Name: Jessica Tooke

Birthday: August 19 1997

Phone Number: 613 919-5912

Email Address: jai857530@gmail.com

Pets (Y/N), if yes what pets and how many: yes service dog

How many people would be living in the home and what is their
relationship to you: Myself

Do you have references for previous tenancies? If so fill in below, If

GUARANTOR INFORMATION (optional)

Name:
Relationship to Applicant:

Phone number:

Email address:

Address:

Phone number:

Driver's License or SIN:

CURRENT/PREVIOUS ADDRESS:

Property Address:

Landlord's Name:

Landlord's Address:

Landlord's Phone number:

Rent $$:

EMPLOYMENT

Employer:

Amount of time employed:

Superviser's number:

Salary/wage:

School (if not employed):

Other sources of income (if not employed):

Other Information:

Have you ever filed for bankruptcy (y/n):

Have you ever been evicted from a tenancy (y/n):

Definitions: Information**
The word “Information” means credit information, personal information, and information
about the services you use that are provided by the Landlord as listed in this rental
application and information relating to your tenancy at the Premises applied for in this rental
application including information regarding the duration of your tenancy, monthly rent,
emergency contacts and any matters relating to your lease/tenancy agreement, including
misrepresentations relating to, defaults under and/or breaches of your lease/tenancy agreement or
any other matter experienced by The Landlord.
“Credit Information” means information about you, including your name, age, date of birth,
occupation, place of residence, previous places of residence, occupancy length, marital status,
co-occupant’s/spouse’s/same sex partner’s name and age, number of dependants, particulars of
education or professional qualifications, field of employment, places of employment, previous
places of employment, employment durations, estimated income, paying habits, outstanding debt
obligations, cost of living obligations, involvement in bankruptcy proceedings or landlord and
tenant disputes, assets, and banking information (including account and credit card information).
“Personal Information” means information about you other than credit information that is
relevant to your suitability as a tenant, including information gathered from references (provided
by you to The Landlord) concerning your character, reputation, physical or personal
characteristics or mode of living or about any other matter or experience concerning you that is
relevant to your suitability as a tenant.
Collection, Use and Disclosure of Information:
In consideration for the Landlord accepting you as a tenant and entering into a lease/tenancy
agreement with you, you expressly consent to authorize the following:

1.The Landlord may obtain information about you through a tenancy and/or credit report
conducted by Rent Check Credit Bureau and as permitted or required by law. You expressly
authorize Rent Check Credit Bureau to provide Credit Information regarding you to The
Landlord.

2.The Landlord may use information about you to determine your suitability as a tenant and as
permitted or required by law.

3.The Landlord may disclose Credit Information about you to Rent Check Credit Bureau, as
permitted or required by law, for inclusion within a database of rent-roll information and within a
tenancy file on you, for purposes of:
0 tenant reporting and credit reporting in accordance with provincial create and
consumer reporting acts;
0 establishing a credit history and or a rental history;
0 maintaining aggregate statistical data for purposes of tenancy and credit scoring;
and
0 supporting the credit approval process in accordance with governing legislation.
4. You expressly authorize Rent Check Credit Bureau to retain positive Credit Information
regarding you for the purposes outlined in section 3 above, for up to 20 (twenty) years. Negative
Credit Information shall be maintained on record in accordance with provincial credit and
consumer reporting acts.

5. You agree that all statements on this Residential Rental Application are true and you expressly
authorize all references given to release information about to The Landlord for verification
subject to sections 1 to 5.
Please provide your consent by checking the following box and signing in the appropriate
space below:

I have read, understood and voluntarily agree to the terms and conditions outlined above:

(applicant's signature)

(date)
(co-applicant signature)

(date)

(guarantor signature)

(date)

Signature space is provided for applicant and co-applicant however Rent Check suggests
that if more than 2 applicants that the landlord provides additional tenancy applicants with
a separate copy of this Residential Rental Application for completion.
**DISCLAIMER: Rent Check does not represent, warrant or guarantee that this Consent
statement will be valid or enforceable in all circumstances or for every landlord. Each
individual landlord should modify the language of this Consent Statement to suit their
individual circumstances, and should obtain legal advice regarding the appropriate consent
to be obtained from their prospective tenants.
Please provide your consent by checking the following box and signing in the appropriate
space below:
The information collected in this form is for the purpose of internal record keeping. The
information contained herein, may be shared with the individuals (i.e. guarantors) during the
leasing process. The applicant(s) hereby certify the information provided above (Applicant
particulars) to be true. The Applicant(s) agree that upon acceptance of the Rental Application by
the Landlord, the Applicant(s) shall forthwith enter into a Tenancy Agreement incorporating the
above information into the Landlord’s usual form, which the Applicant(s) have been given the
opportunity to review. The undersigned consents to the obtaining of such information, as the
Landlord may deem necessary at any time in connection undersigned in conjunction with the
premises hereby applied for or any renewal or extension of my/our tenancy agreement. The
undersigned also consents to the disclosure of any information concerning the undersigned to
any credit reporting agency or to any person with whom the undersigned has or proposes to have
financial relations.

I understand and accept the residence for which I have applied, to be in “as in” condition
subsequent to any special clauses agreed to in writing by The Landlord and the Tenant at
The Landlord's sole discretion. I understand that upon the signing of this application and
receipt by The Landlord of my first and last month’s rent, I have committed to the terms
of my lease, including the length of the term. The full terms of the lease apply.
I agree to the terms cited above:

(applicant signature)
(date)

(co applicant signature)

(date)

(guarantor signature)

(date)