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Country Home Rentals Application
Applicant 1
*
Indicates required field
Name
*
First
Last
Phone Number
*
Email
*
Date of Birth
*
List any other people you plan to live with you or dependents names and ages
*
Residential History
List your last 1-3 apartments or places of residence.
Previous Apartment 1
Address
*
Line 1
Line 2
City
State
Zip Code
Country
How long at this address?
*
Landlord's Name
*
Landlord's Phone
*
Previous Apartment 2
Address
*
Line 1
Line 2
City
State
Zip Code
Country
How long at this address
*
Landlord"s Name
*
First
Last
Landlord's Phone
*
Previous Apartment 3
Address
*
Line 1
Line 2
City
State
Zip Code
Country
How long at this address
*
Landlord's Name
*
First
Last
Landlord's Phone
*
Employment Details
Please list employment information. If you are a student or unemployed write none and explain sources of income below.
Employer
*
Position
*
Supervisor's Name
*
First
Last
Supervisor's Phone
*
Date Hired
*
Salary
*
Do you receive income from any other sources such as Pension Benefits, Social Assistance or other?
*
Character Reference
(Not a family member or friend.)
Reference Name
*
First
Last
Reference Phone
*
Reference Relationship
*
No Dogs
I understand this is a no dog apartment. Exceptions can be made for certain other house pets. Please ask.
*
Yes
Not Entering Lease
I understand that this is an application and not a formal lease agreement with the Country Home Rentals. I understand that a signed lease (in some cases with a guarantor signature), a security deposit of $1000 ($500 for the Studio Apartments)
and first month’s rent
are required to secure the apartment for tenancy.
Credit Check
I declare that the information I have provided is accurate. I authorize the individual or organization to who application is submitted to contact my references and all other persons that I have named in this application to obtain information about the status of my credit in order to assess my suitability as a tenant/lessee. I further agree to allow my credit to be checked by a reputable credit firm as evaluated by the landlord.
Credit Check
*
Agree
Today's Date
*
By checking this box I agree that the information on this form is correct to the best of my knowledge and I am applying to rent the said apartment on this form.
*
Agree
Submit
