Residential Rental Application

RESIDENTIAL RENTAL APPLICATION
Please provide details below. You may complete the form entirely and submit electronically directly to Devereaux Property Management LTD., you may select to omit some details that you are not comfortable providing electronically and request that we contact you for the missing details by selecting the box at the end of the application, or you can fill in the form, print and drop off in person at our office. Our office is located upstairs at the Parkland Mall in Red Deer, Unit #905, 4747 67 Street.
Please indicate which building you are requesting
Desired move in date
MM slash DD slash YYYY
Applicant(s)
Name*
First Last
Email Address*
Date of Birth
MM slash DD slash YYYY
Home Phone*
Cell Phone*
Please tell us about your Dependant(s)
Dependant Name Date of Birth
Tendency Information
Current Address*
Street Address Address Line 2 City Province Postal Code
How long have you lived at this address?
Lease expiry date
MM slash DD slash YYYY
Has Notice Been Given?*
Name of Landlord
Landlord Contact Number
Previous Address
Street Address Address Line 2 City Province Postal Code
How long did you reside at this address?
Name of Landlord
Landlord Contact Number
Employment Information
Employer Name or Company Name
Contact Number for Employer
Your Position
Length of Employment
Gross Monthly Salary
Emergency Contact Information
Name
First Last
Relationship
Phone Number
Vehicle Information
Make
Model
Year
Driver's Licence Number
Banking Information
Name of Bank
Address of Bank
Phone Number of Bank
References
Reference Information | No Friends Or Relatives Please
Full Name Phone Number Relationship

Please add a minimum of three (3) references
Background Check

If we perform a criminal or credit background check is the anything you wish to disclose at this time or wish to comment on?
Background Check
By submitting this application I declare the information I have provided is accurate. I authorize Devereaux Property Management Services LTD. to contact my references, current as well as past landlords and any other persons I have named in my application. I understand that a credit and/or criminal record check may be performed to determine my suitability as a tenant. By clicking the I agree checkbox below you are confirming that you have read the above terms and are in agreeance.
Submission Agreement*
- I agree
- I do not agree
All applications are confidential we do not sell or use your information for reasons other than this application for rental accommodations.
Is there more than one applicant for this unit?*
- No
- Yes
CAPTCHA
Applicant(s)
Name
First Last
Email Address
Date of Birth
MM slash DD slash YYYY
Home Phone
Cell Phone
Please tell us about your Dependant(s)
Dependant Name Date of Birth
Tendency Information
Current Address
Street Address Address Line 2 City Province Postal Code
How long did you reside at this address?
Lease expiry date
MM slash DD slash YYYY
Has Notice Been Given?*
Name of Landlord
Landlord Contact Number
Previous Address
Street Address Address Line 2 City Province Postal Code
How long did you reside at this address?
Name of Landlord
Landlord Contact Number
Employment Information
Employer Name or Company Name
Contact Number for Employer
Your Position
Length of Employment
Gross Monthly Salary
Emergency Contact Information
Name
First Last
Relationship
Phone Number
Vehicle Information
Make
Model
Year
Driver's Licence Number
Banking Information
Name of Bank
Address of Bank
Phone Number of Bank
References
Reference Information | No Friends Or Relatives Please
Full Name Phone Number Relationship

Please add a minimum of three (3) references
Background Check

If we perform a criminal or credit background check is the anything you wish to disclose at this time or wish to comment on?
Background Check
By submitting this application I declare the information I have provided is accurate. I authorize Devereaux Property Management Services LTD. to contact my references, current as well as past landlords and any other persons I have named in my application. I understand that a credit and/or criminal record check may be performed to determine my suitability as a tenant. By clicking the I agree checkbox below you are confirming that you have read the above terms and are in agreeance.
Submission Agreement*
- I agree
- I do not agree
All applications are confidential we do not sell or use your information for reasons other than this application for rental accommodations.
Name
This field is for validation purposes and should be left unchanged.

Dependant Name	Date of Birth

Full Name	Phone Number	Relationship

Dependant Name	Date of Birth

Full Name	Phone Number	Relationship

Applicant(s)

Tendency Information

Employment Information

Emergency Contact Information

Vehicle Information

Banking Information

References

Background Check

Applicant(s)

Tendency Information

Employment Information

Emergency Contact Information

Vehicle Information

Banking Information

References

Background Check