Rental Application Form

Fill out this application if you are interested in property rentals through Amos Realty. If you would like to print out a PDF version of the form you can click here, and then fax your completed form to us at (250) 498-3455. If you would like to fill the form out below, please do so and we will contact you regarding your application.

References will be checked within 72 hours - please allow this time for processing.

APPLICATION TO RENT

Each Individual Occupant Who is Responsible for Rent Payment
MUST Complete A seperate Application Form
Rent Range Are you a Smoker?
Desired Town / City Date Required
Bedrooms Required    
First Name Last Name
Middle Initial Date of Birth
Email Address Drivers License Number
Home Phone Number    
Present Home Address
Landlord/Contact Landlord/Contact Phone
Can Landlord be contacted? If no, please explain briefly.
City Province
Length of Time Reason for Leaving
Previous Home Address
Landlord/Contact Landlord/Contact Phone
Can Landlord be contacted? If no, please explain briefly.
City Province
Length of Time Reason From Leaving
Next Previous Home Address
Landlord/Contact Landlord/Contact Phone
Can Landlord be contacted? If no, please explain briefly.
City Province
Length of Time Reason From Leaving
PROPOSED OCCUPANTS
Describe each & every person who will occupy the premises.
Do you have any Pets? Do you have any liquid filled furniture?
If yes, please describe If yes, please describe
EMPLOYMENT / FINANCIAL INFORMATION
Present Occupation Employer Name
How long with this employer Employer Phone
Name of Supervisor Employer Address
Previous Occupation Employer Name
How long with this employer Employer Phone
Name of Supervisor Employer Address
Gross Income $   per (year/week/day) 
SPOUSE EMPLOYMENT / FINANCIAL INFORMATION
Present Occupation Employer Name
How long with this employer Employer Phone
Name of Supervisor Employer Address
Previous Occupation Employer Name
How long with this employer Employer Phone
Name of Supervisor Employer Address
Gross Income $   per (year/week/day) 
EMERGENCY INFORMATION
In case of emergency notify Address
Phone Relationship
VEHICLE INFORMATION
Vehicle Make Vehicle Model
Vehicle Year License No.
Vehicle Make Vehicle Model
Vehicle Year License No.
Have you ever filed for bankruptcy? Have you ever been evicted or asked to move?
If yes, date bk filed and describe If yes, please describe
APPLICANT AUTHORIZATION
Applicant represents that all the above statements are true and correct and hereby authorizes landlord/agent to verify the above items including, but not limited to, the obtaining of a credit report and agrees to furnish additional credit references upon request.
I agree to to these terms and conditions:

Only qualified applicants will be contacted