APPLICATION FOR TENANCY

THIS APPLICATION WILL BE CONSIDERED WITH ALL OTHER APPLICATIONS. PLEASE COMPLETE ALL BLANKS ON THIS APPLICATION FORM

A. l/We the undersigned, understand known as the applicant, offer to rent residential premises In British Columbia known as (address you are applying for)
2100 The date occupancy desired
________________________________at
a monthly rent of $ _____________plus
parking $__________
totaling $ ___________
911 Cloverdale Road
2100
0
is:__________________________
Where did you see the ad?__________________
Craigslist.com
September 1st, 2014
I/We understand that when this offer is accepted, and a tenancy agreement is signed, it becomes a binding agreement. A SECURITY DEPOSIT will be required before
possession, which may be held by the Landlord/Landlord's Agent, who may hold it in a general account until the tenancy ends. It is agreed that rent IS payable
promptly in advance by the first day of each month.
B. PETS, BARBECUES AND WATER BEDS are not allowed without advance written permission of the Landlord/Landlord's Authorized Agent See terms in the
Residential Tenancy Act on these subjects. PETS: if the property you are applying for allows pets, please provide description of pet(s)___________________________
0
No pets (circle if applicable).
Please advise if you are smokers or non-smokers: _________
Non-smoker

Benjamin Daniel Wagg

May 11th, 1995
C. Applicant's full name: _________________________________________________________
Date of birth: __________________
250-857-0788
752 836 510
9910839@gmail.com
Social insurance number: ____________________________
Phone no: Cell/other no.: ________________________
Email Address: ____________________

Campbell
3850 Asman Turn
Own
4 Months
V9H1J2 How long there? _______Rent
River
Present address_______________________________
City __________
Postal code: __________
or own? _____________
250-923-9239
N/A
Rent rate? $ ______________
Building
manager/landlord/listing
realtor:
______________________________
Phone:
______________________________
0
Reason for leaving? ______________________________________________________________________________________________________________
This is my parents house, that I stayed at for the summer.
3800 Finnerty Road
Rent
V8W 2Y2 How long there? 8Months
Victoria Postal code: __________
Previous address_______________________________
City __________
_______Rent or own? _____________
$620
(250) 721-8395
N/A
Rent rate? $ ______________
Building manager/landlord/listing realtor: ______________________________
Phone: ______________________________
I lived in an on campus Uvic location. I left because I wanted a quieter environment.
Reason for leaving? ______________________________________________________________________________________________________________

Employment / Income information (must be completed; we will verify income source/amount. You can attach info.)
N/A
Self Employed
Campbell River
Months Contact name: ____________________________
Current Employer: _______________________City
___________________How
long at job? 2
_________
$1500
Contact's phone no. __________________________
Your position:__________________________________________
Salary: $ ________________________
250-857-0788
Owner
N/A
Previous Employer: _______________________City
___________________How long at job? _________ Contact name: _____________________________
Contact's phone no. __________________________ Your position:__________________________________________ Salary: $ ________________________
$1000
Supplementary from parents Monthly income: $ _______________
D. Income source if not employed: ___________________________
Contact name for
Russ
&
Catherine
Wagg
250-202-9244
verification:__________________________ Phone number: _____________________
Please be advised that self-employed applicants will be asked to provide proof of income.

Cam Fairweather
E. The full names of all OTHER ADULT PERSONS / (19 years or older) to live In the rental (other than yourself:_____________________________________________
______________________________________________________________________________________________________________________________________
N/A
The full names and ages of all minor persons (including infants) to live in the rental are: _______________________Age:___
___________________________Age:___ _______________________Age:___ The total number of all persons in the tenancy is: _____

F. Personal/family references
Russ Wagg
250-202-9244
3850 Asman Turn Phone: _______________
Next of kin: ______________________
Address: ______________________
Bob Haugen
Personal reference: _________________
Address: _____________________
Phone: _______________
304, 853 North Park
250-920-0505
(This should be a non-family member)

N/A
G. Automobile Make: _______________
Model: __________ License: ______ Colour: ___________
X
H. Insurance: Do you presently insure your personal belongings and any third party liability? YES __ NO __
Carrying insurance is the tenants' responsibility; the landlord is not responsible for personal belongings of tenants.

I. CONSENT: FOR THE PURPOSE OF DETERMINING WHETHER MY/OUR APPLICATION FOR TENANCY IS ACCEPTABLE, I/WE HEREBY CONSENT TO THE LANDLORD;
I.
OBTAINING CREDIT/PERSONAL INFORMATION REPORTS ON ME/US (INCLUDING A SPOUSE) FROM ONE OR MORE CONSUMER REPORTING AGENCIES OR
FROM OTHER SOURCES Of INFORMATION. I/WE AUTHORIZE THE REPORTING AGENCIES AND OTHER PERSONS TO DISCLOSE INFORMATION ON ME/US TO
BW
THE LANDLORD OR LANDLORD'S AGENT. ____(Please
initial)
BW
II. I/WE AUTHORIZE THE AGENT/LANDLORD TO OBTAIN A CRIMINAL RECORD CHECK. _________
(Please Initial)
BW
III. This information may be reviewed by the owner of the property for which you are applying, at Owners' request. ____(Please
initial)
PLEASE READ, DATE: AND SIGN APPLICATION FORM. I/WE ACKNOWLEDGE THAT APPLICATIONS WILL BE CONSIDERED BY THE LANDLORD IN THEIR ABSOLUTE
UNFETTERED DISCRETION WITHOUT REFERENCE TO THE DATE OR TIME OR APPLICATION OR ANY CRITERIA OTHER THAN THOSE SET BY THE LANDLORD
Admiral Inn
July 31st
14
DATED AT (location where you are signing), _____________________B.C.
on __________________________
20 ____
APPLICANT'S SIGNATURE
Ben Wagg
____________________________________________________
Please note that each applicant must fill out a separate application to rent.

PEMBERTON HOLMES PROPERTY MANAGEMENT 112-2244 Sooke Road, Colwood, BC, V9B 1X1 TEL: 250-478-9141 FAX: 250-478-9103 info@phpm.ca www.phpm.ca