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Quebec Application for Rental Form

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Quebec Application for Rental Form
Quebec Application for Rental Form
www.trianon.ca [email protected] 514-937-6134
for: Location of Building: _____________________________
Apt. # ___________
Family Name: First Name:
Term of Lease: Rental: $
Garage Needed: Yes No Deposit: $
Heating/Hot water paid by: Number of occupants:
Electricity paid by: Special clauses:
Stove & Fridge by:
Dishwasher included: Yes No
Name/Address/Tel. of Owner of building:
Current address:
Telephone home:
Telephone work:
Quebec Driver’s license No. (optional)
Social Insurance No. (optional)
Quebec Health Insurance No. (optional)
Bank: Occupation:
Bank address/tel: Name & Address of Employer:
Account No. (optional) Telephone:
Relatives (or friends): Telephone:
I hereby agree to sign the regular lease of Trianon Properties, according to clauses and conditions therein appearing, providing this
rental application be accepted by the owner or its duly authorized representative within ten (10) days from the signatures of these
present. Should this application be refused, the amount of $ ________ paid on account this date will be reimbursed to the
undersigned. In case of withdrawal of my offer, my deposit will be lost. The applicant waives any claim for damages by reason of
non-acceptance of this application, which the owner may reject without stating any reason whatsoever for doing so.
Authorized by: __________________________ Date: _____________________
Signature of Lessee: _________________________ Date: _____________________
Quebec Application for Rental Form