Anchor Group Atlantic Limited
Box 500, 3 Anchor Drive
Halifax. N.S. B3N 3H7
Web Site. http://www.anchorgroupatlantic.com

Application for Leasing

Name of Applicant:-.....................................................................
Phone#:- ..............................................................
Present Address:-.......................................................................
How long there:- ...................................................
Name of present Landlord:-..........................................................
Phone#:- ..............................................................
Reason for leaving:-.....................................................................
Please select one of the following:- Age:-20-30 ( ) 30-40 ( ) 40-50 ( ) 50-60 ( ) Semi-Retired ( ) Retired ( )


Employment Information.

Occupation:- ..............................................................................
Name of Employer:- .............................................
Monthly Income:-........................................................................
How long there:- .........................................................................
Sin No:- ..............................................................
Supervisor's Name:- ....................................................................
Phone #:- ............................................................


Leasing Information
(lease period 1 year)

Date of occupancy required:- .......................................................
Number of bedrooms:- ..........................................
No. of persons to occupy apartment:- Names of persons to occupy apartment(inc. age if under 18)
1. ...................................................................................
2. .......................................................................
3. ...................................................................................
4. .......................................................................
No. of Cars:- ...........................Year:- .....................Make:- ...................................Model:- .......................................


Next of Kin References(in case of Emergency.

Name:- .....................................................Relation:- ...........................................Phone#:- ......................................
Name:- .....................................................Relation:- ...........................................Phone#:- ......................................


Banking Information

Bank:- ................................................Branch:- ..................................................Phone#:- ......................................

Apartment Information

Apt# applying for:- .......................................................Address:- .............................................................................
Rent will be $ ......................per month in advance. Security Deposit will be $ .............................................................
Security deposit Paid on:- ....................................by Cash:- .................................Cheque:- ......................................

The Landlord will not process an incomplete application

Owner and/or Agent for the owners reserve the right to reject this application and to refuse possession of the
above mentioned accommodation.

NOTE: BEFORE A LEASE IS SIGNED, THE LANDLORD REQUIRES THAT THE SECURITY DEPOSIT
IS PAID AND TWELVE(12) POSTDATED CHEQUES IN THE AMOUNT OF THE MONTHLY RENT BE

PROVIDED TO THE LANDLORD.
By signing, you hereby grant permission, and are aware that a landlord reference, employment
verification and a credit report may be obtained in the processing of this application.

Signature:- ................................................................................ Date:- ..............................................................
 
Print this form. Fill in your details and post to the address above.