Prospective Tenant Application Form

All information you provide will be kept confidential.

Rental address:

Apt:

Date apartment needed:

APPLICANT’S PERSONAL INFORMATION:

Applicant’s name:

Date of birth:

Present street address:

Marital status:

Mailing address:

Email address:

Phone:

Employer:

How long?

1. Are you presently on Government Assistance?

YesNo

2. Do you have any pets?

YesNo

3. Are you paying rent at your present place of residence?

YesNo

4. Have you ever been served an Order of Possession?

YesNo

5. Have you ever been served an Order of Eviction?

YesNo

6. Do you have any children?

YesNo

If yes, please supply their names and ages.

7. Have you ever been refused service or disconnected by a public utility (Manitoba Hydro, Centra Gas, MTS) due to non-payment of your account?

YesNo

8. Please furnish us with two personal financial references (ie. Previous landlords, employers). No family members please.

Relation to you:

Phone no.:

Relation to you:

Phone no.:

This is a legal binding document and failure to provide accurate information will void your application and may be cause for eviction in future. Applicants, if accepted, will be notified within 48hrs. If not notified, application has been denied.

Testimonials

Places where we operate

And our mailing address is:
PO Box 261, La Broquerie Manitoba R0A 0W0

Contact us

You can write to us, phone us or drop in to our office to see us. You can use the form below if you'd like to send us your questions or comments by email and we will answer you as quickly as possible.

Send your message

Mailing address
PO Box 261
La Broquerie Manitoba
R0A 0W0

Cell: 204-371-5738