Form 410 — Rental Application (Ontario)

Rental Application

Residential

Form 410

for use in the Province of Ontario

I/We hereby make application to rent

from the day of 20 at a monthly rental of $

to become due and payable in advance on the day of each and every month during my tenancy.

Applicants

1. Applicant #1

Date of birth

SIN (Optional)

Driver's Licence No.

Occupation

2. Applicant #2

Date of birth

SIN (Optional)

Driver's Licence No.

Occupation

Other Occupants

3. Name

Relationship

Age

Name

Relationship

Age

Name

Relationship

Age

Do you have any pets? If so, describe

Why are you vacating your present place of residence?

Last Two Places of Residence

Applicant #1

Present Address

From

Name of Landlord

Telephone

Prior Address

From

Name of Landlord

Telephone

Applicant #2

Present Address

From

Name of Landlord

Telephone

Prior Address

From

Name of Landlord

Telephone

Present Employment

Applicant #1

Employer

Business address

Business telephone

Position held

Length of employment

Name of supervisor

Current salary range: Monthly $

Applicant #2

Employer

Business address

Business telephone

Position held

Length of employment

Name of supervisor

Current salary range: Monthly $

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© 2023, Ontario Real Estate Association ("OREA"). All rights reserved. This form was developed by OREA for the use and reproduction by its members and licensees only. Any other use or reproduction is prohibited except with prior written consent of OREA. Do not alter when printing or reproducing the standard pre-set portion. OREA bears no liability for your use of this form. Form 410 Revised 2022 Page 1 of 2

Prior Employment

Applicant #1

Employer

Business address

Business telephone

Position held

Length of employment

Name of supervisor

Salary range: $

Applicant #2

Employer

Business address

Business telephone

Position held

Length of employment

Name of supervisor

Salary range: $

Banking Information

Name of Bank

Branch

Address

Chequing Account #

Savings Account #

Financial Obligations

Payments to

Amount: $

Payments to

Amount: $

Personal References

Name

Address

Telephone

Length of Acquaintance

Occupation

Name

Address

Telephone

Length of Acquaintance

Occupation

Automobile(s)

Make

Model

Year

Licence No.

Make

Model

Year

Licence No.

The Applicant consents to the collection, use and disclosure of the Applicant's personal information by the Landlord and/or agent of the Landlord, from time to time, for the purpose of determining the creditworthiness of the Applicant for the leasing, selling or financing of the premises or the real property, or making such other use of the personal information as the Landlord and/or agent of the Landlord deems appropriate.

The Applicant represents that all statements made above are true and correct. The Applicant is hereby notified that a consumer report containing credit and/or personal information may be referred to in connection with this rental. The Applicant authorizes the verification of the information contained in this application and information obtained from personal references. This application is not a Rental or Lease Agreement. In the event that this application is not accepted, any deposit submitted by the Applicant shall be returned.

(Signature of Applicant #1)

(Date)

Telephone

Email Address

(Signature of Applicant #2)

(Date)

Telephone

Email Address