Ph: 250-475-2005

Secure Tenancy Application

An asterix (*) denotes a required field.

*Address Applied For:
Where did you hear about the Vacancy?:
Preferred Occupancy Date:
*Email Address:
Alt Email Address:
*Name of Applicant:
*Phone #:
*S.I.N. #:
Driver's Licence:
*Date of Birth:
Name of Spouse:
Date of Birth:
S.I.N. #:
Spouse’s Phone Number:
*Present Address:
*Postal Code:
*How Long?:
*Reason for Leaving:
*Present Landlord's Name:
*Phone #:
Previous Address:
Postal Code:
Previous Landlord's Name:
Phone #:
*Description for Pets:
*Next of Kin:
*Phone #:
*Present Employer:
*Gross Monthly Income:
*How Long?:
Employer's Address:
Phone #:
Employed as:
Supervisor's Name:
Spouse's Employer:
Phone #:
Automobile Make:
Licence Plate #:
Credit Card:
Account #:
*Bank & Location:
*Account #:
Contents Insurance Agent:

I hereby authorize Cornerstone Properties Ltd. to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of a credit account or any other direct business requirement. This consent is given pursuant to section 4 of the Personal Information Protection Act, S.B.C. 2003

Where a Lease exists and it commences upon any day other than the first day of a month, rent will be taken to the end of that month and a tenancy will become an annual Lease tenancy from the first of the following month.