Note: This application is for initial screening purposes only.
 
  (*) Indicates required fields
  Name of Applicant (*)
 Date of Birth (*)
 SIN (*)
 Driver's License
 Province
  Name of Co-Applicant
 Date of Birth
 SIN
 		Driver's License
 Province
 
  Number of Bedrooms Desired
Studio 1 2 3 or More		 Move In Date
 # of Occupants
 
  Applicant's Street Address
 E-mail:
  City
 Province
 Postal Code
 Phone (*)
  Present Address is: Own Home Parent's Home Rented Home Rented Apartment
 
  If Rent: Present Landlord or Apartment Community
  If Own: Name of Bank or Mortgage Company
  Street Address of Present Landlord/Mortgage Company
  City
 Province
 Postal Code
 Phone
  EMPLOYMENT INFORMATION
  Present Employer
 Position
 Annual Income  
 How Long
 Phone
  Supervisor's Name
 Position
 Phone
  Employer's Street Address
 
City
 Province
 Postal Code
 
  Previous Employer
 Position
 Annual Income  
 How Long
 Phone
  Supervisor's Name
 Position
 Phone
  Previous Employer's Street Address
 
City
 Province
 Postal Code
  List Any Other Asset or Income Sources & Account Numbers (i.e. savings accounts, stocks, bonds, capital investments, etc.)
  CREDIT INFORMATION
  Auto Loan Institution:
Monthly Payment:
 Balance:
  Other Credit Reference:
 Monthly Payment:
 Balance:
 
Have you had any credit problems or litigation?
(i.e. Past due accounts, evictions, judgements, bankruptcies, foreclosures)
 Yes No
If yes, please give details and dates:
 
  In Case of Emergency Notify
 Relationship
 Phone
 
  Please let us know any additional information you feel might be helpful
PLEASE READ CAREFULLY AND CHECK BELOW
Applicant represents that all above statements are true and complete. Applicant hereby authorizes verification of above information, references and credit records, and applicant releases from all liability or responsibility all persons and corporations requesting or supplying such information. Applicant acknowledges that false information may constitute grounds for rejection of this application, termination of right of occupancy and/or of deposits and may constitute a criminal offense under the laws of this Province.

  I have read and agree to the provisions as stated

 

Complete the form above and mail or fax to:

Schiffer Properties Corp.
534 Taylor Road
Victoria, B.C. Canada V9C 3Y7
 Phone: 250-744-2955
Fax: 250-744-5845
Email: schifferproperties@shaw.ca

<<BACK