Rental Application Page 1Page 2Page 30% Complete1 of 3 Community of Interest * SelectHalifax CommunityDartmouth CommunityGuysborough CommunityLunenburg CommunityPort Hawkesbury CommunityBridgewater CommunityCanso Community Move-in Date: * Unit # (if known): Unit Type: * SelectStudio1-Bedroom2-Bedroom3-Bedroom Applicant Name: Applicant Name: First First Last Last Do you have a Co-Applicant? * Yes No Date of Birth: * Social Security Number: Current Address: * City: * Province: * Postal Code: * Email Address: * Phone Number (mobile): * Phone Number (home): How many adults are in your household? (18 years and older) * How many children are in your household? * Do you require any accessibility modifications? Vehicle Make: Vehicle Model: Vehicle Year: Vehicle Color: Applicant Employer Name: * Employer Contact: * Position: * Salary: * Length of Employment: * Do you currently receive any additional income, financial assistance, or funding from government programs (e.g., disability support, income assistance, child benefits, or other specific circumstances)? * SelectYesNoN/A If yes, what source? Monthly Amount: Applicant Rental History (Last 3 Years) Address: * Landlord Name: Landlord Contact: Ownership * SelectOwnedRentedN/A Dates of Residency: * Current Monthly Rent/Mortgage: * Reason for Moving: * Have you ever received an eviction notice? If yes, why? * If you are human, leave this field blank. Next
