RENTAL APPLICATION; for #19 4729 18th Street Lloydminster Saskatchewan 3 bedrooms, 3 bathrooms, 1 car garage, 5 appliances. With D. Iskra 635 Glover Rd. Port McNeill, B.C. V0N 2R0 Full Name;______________________________________________________________Date________ Co Applicant name;_______________________________________________________ Telephone;____________________cel______________________ Present Address;___________________________________________ Present Landlord’s name and phone number:________________________________________________ EMPLOYER:____________________________ Supervisor____________________________________ Supervisor phone #________________________Position held__________________________________ How long____________________________Monthly Income___________________________ Co Applicant Employer:____________________________ Supervisor____________________________________ Supervisor phone #________________________Position held__________________________________ How long____________________________Monthly Income___________________________ Name of Bank;__________________________Branch______________________acct #____________________ Emergency Contact name;____________________phone #______________address_________________________ Established Referances; Name:_____________________________________phone #__________________________________________ Name:_____________________________________phone #__________________________________________ Name:_____________________________________phone #__________________________________________ Vehicle make & model_______________________________plate # _____________________________________ Vehicle make & model_______________________________plate #___________________________________ I hereby authorize D. Iskra, the landlord and owner to verify all references and financial information as requested. Signature________________________________________Witness____________________________________ Signature________________________________________Witness____________________________________
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