Green Concept Property Investiments

Please note that one complete, signed form is required for EACH person over the age of 18 who will be occupying the residence.This form is handled through a secure internet server. If you prefer, you may download our printer-friendly form and fax or mail us your application.

Download a form in PDF format that you can then fax to us.

Note, if you fill out the form below we need your signature which you can write on a piece of paper, scan it and convert it to an image file (.jpg, .gif or .png) then attach it to this form by using the browse button to select the file off your computer.

Personal Information

Name:
E-mail:
Social Insurance Number
Date of Birth (DD-MM-YY)	- -
Driver's License Number
Driver's License Expiry Date (DD-MM-YY)	- -
Work Phone Number
Home Phone Number
Cell Phone Number

Current Address

Address:
City:
Province:
Do you rent or own the place you are currently living in?	Rent Own
Amount of rent/mortgage
Payment Method
Postal Code:	Required
Date Moved In (DD-MM-YYYY):	- -
Date current lease expires (DD-MM-YYYY)	- -
Name of Landlord:
Landlord's Phone Number:
Reason for Moving:
Have you given your landlord 30 days notice?	Yes No

Previous Address

Address:
City:
Province:
Did you rent or own this property?	Rent Own
Amount of rent/mortgage:
Payment Method
Postal Code:	Required
Date Moved In (DD-MM-YYYY):	- -
Date Moved Out: (DD-MM-YYYY)	- -
Name of Landlord:
Landlord's Phone Number:
Reason for Moving:

Pets

Please describe your pets:

Children (Under 18) to Occupy the Premises

Child's Name and Age:
Child's Name and Age:
Child's Name and Age:

Vehicle Information

Vehicle Make and Model:
Model Year:
License Plate Number:

Employment Information - Current Employment

Occupation:
Gross Income:	dollars per month
Company Name:
Supervisor's Name:
Supervisor's Phone Number:
Length of Employment:

Additional Information

Other regular sources of income (such as child support, family allowances, or other income)
Amount per month

Additional Financial Information

Have you ever filed a petition for bankruptcy?	Yes No
If so, how long ago?
Have you ever been evicted or asked by a landlord or his agent to leave any rented premesis?	Yes No
If yes, explain when and why?
Have you ever not paid rent when due?	Yes No
If so, why?
Are you required to pay child support or alimony?	Yes No
If so, how much per month?

Previous Employment:

Occupation:
Gross Income: per month
Company Name:
Supervisor's Name:
Supervisor's Phone Number:
Length of Employment:

Emergency Contact

Name:
Relationship:
Phone Number:

Credit Information

Name of Bank:
Branch Address:
Account Number:
Type of Account:

Name of Bank:
Branch Address:
Account Number:
Type of Account:

References - Do not list relatives

Reference 1
Name:
Occupation:
Phone Number:
How do you know this person?
How long have you known this person?

Reference 2
Name:
Occupation:
Phone Number:
How do you know this person?
How long have you known this person?

Reference 3
Name:
Occupation:
Phone Number:
How do you know this person?
How long have you known this person?

Comments

Please use this space to tell us anything else about yourself...

Declaration

I, the applicant, testify that all the above is true and correct. I understand and acknowledge that no application will be considered complete until the Landlord receives a deposit in the amount of $200 in the form of certified cheque, cash or money order on the understanding that if my offer is accepted, the deposit shall be retained by the Landlord as a 'Deposit' in accordance with the provisions of the Lease Agreement, and if my offer is not accepted, the full deposit will be refunded to me. However, if my offer is accepted and I cancel the application or fail to execute the Lease Agreement when prepared and presented, then I agree that the said deposit shall be absolutely forfeited to the Landlord. This shall be considered liquidated damages and not a penalty. By submitting this application I hereby authorize verification of the above information with credit reports and contacting of any of the aforementioned people. I understand and acknowledge that should any of the information I have submitted be found to be false or misleading, the Landlord may terminate any agreement entered into and the Landlord will deduct all reasonable expenses associated with credit checks, background checks, time spent, and/or lease termination from any deposits held in trust.

By submitting this application, I hereby make application to rent housing accomodations and if accepted, upon signing a lease rental agreement, agree to pay all sums due, including the required security deposit (equal to one month's rent), prior to occupancy.

Our Privacy Policy
We respect your privacy - the information collected here will not be given to any third party and will only be used to verify your employment and credit information and evaluate you as a potential tenant. We will not keep your application longer than 30 days unless you sign a lease agreement with us, in which case your application and other information will be securely stored for the duration of your tenancy with us. If you prefer not to fill out this on-line form we would be happy to fax you an application form, or set up an appointment to meet with you in person.

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