Residential Tenancy Rental Application Form Page 3
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*CONTACT FOR EMERGENCIES
(Must be completed with full First then Last Name)
Name:
Address:
Telephone:
In case of Emergency (cell):
Contact Name:
Relationship:
Telephone Daytime:
In the evening:
Information
The word “Information” means credit information, personal information, information about the services you use that are
supplied by the Housing Provider and information relating to your tenancy at the Premises applied for in this
application including information regarding the duration of your tenancy, monthly rent, emergency contacts and any
matters relating to your lease/tenancy agreement, including misrepresentations relating to, defaults under and/or breaches
of your lease/tenancy agreement.
“Credit Information” means information about you, including your name, age, date of birth, occupation, place of
residence, previous places of residence, occupancy length, marital status, co-occupant’s/spouse’s/same-sex partner’s name
and age, number of dependants, particulars of education or professional qualifications, places of employment, previous
places of employment, employment duration, estimated income, paying habits, outstanding debt obligations, cost of living
obligations, involvement in bankruptcy proceedings or Housing Provider and tenant disputes, assets, and banking information
(including account and credit card information).
“Personal Information” means information about you other than credit information that is relevant to your suitability as a
tenant, including your social insurance number (optional), driver’s license number, vehicle license plate number, vehicle
make and year, and information from references which you provide about your character, reputation, physical or personal
characteristics or mode of living or about any other matter concerning you that is relevant to your suitability as a tenant.
Collection, Use and Disclosure of Information:
In consideration for the Housing Provider accepting you as a resident and entering into a lease/tenancy agreement with
you, you expressly consent to and authorize the following:
1.
The Housing Provider may obtain Information about you through a tenant check and/or credit or consumer report
conducted by Rent Check Credit Bureau and as permitted or required by law. You expressly authorize Rent Check
Credit Bureau to provide Information regarding you to the Housing Provider.
2.
The Housing Provider may use Information about you to determine your suitability as a tenant and as permitted or
required by law.
3.
the Housing Provider may disclose Information about you as permitted or required by law and to Rent Check Credit
Bureau in order to be included within a database of rent roll information, and/or within a tenancy file on you, for
purposes of:
tenant reporting and credit reporting in accordance with the Consumer Reporting Act (Ontario);
establishing a credit history and a rental history;
comparing with aggregate statistical data for purposes of tenancy and credit scoring; and
supporting the credit approval process
4.
You expressly authorize Rent Check Credit Bureau to retain Information regarding you indefinitely for the purposes
outlined in section 3 above, subject to any applicable legal restrictions.
5.
You expressly authorize Rent Check Credit Bureau to disclose Information regarding you to its members and
subscribers as required or permitted by law and for the purposes outlined in section 3 above.
6.
You agree that you will not withdraw your authorization and consent to the collection, use and disclosure of Information
about you by Rent Check Credit Bureau as outlined in sections 1 to 5 above.
7.
You agree that all statements on this Residential Rental Application are true and you expressly authorize all references
given to release information about you to the Housing Provider for verification subject to sections 1 to 5.
Optimal Property Management Inc. 3-35 Stone Road, P.O. 218, Ancaster, ON L9K 1S5
Tel: 905-648-6440
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