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Rental City Rental Order
Renter's Name   Birthdate Choose The Store Closest to You
  / /
Spouse or Roommate's Name
Relationship to Renter
Birthdate
    
   
Address
Apt. #
City
Province
Postal Code
How Long?
Phone #
Phone in Whose Name?
Other Phone #
  - -    
Utilities in whose name?
Make & Model Auto
Colour
Tag #
Province Registered
Where is auto financed?
Current Landlord or Mortgage Company
Phone #
Mo. Pymt Amt
Move In Date
Lease/Mortgage in Whose Name?
Length of Lease?
- - / /
If Length of Residence at current address is less than 1 year, give previous address:
Previous Address
City
Prov
Postal Code
Phone #
How Long?
Previous Landlord
- -

Renter's Employment or Income Information
Where Employed/Source of Income Address City Prov Phone #
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Position
How Long with Company
Shift
Paid
Day(s) or Date(s) Paid
Take Home Pay

Spouse or Room-mate Employment or Income Information
Where Employed/Source of Income Address City Prov Phone #
- -
Position
How Long with Company
Shift
Paid
Day(s) or Date(s) Paid
Take Home Pay

Personal References (At least 2 should be relatives with a different address)
Parents Address City Prov Postal Code Phone # Relationship
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Name Address City Prov Postal Code Phone # Relationship
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Name Address City Prov Postal Code Phone # Relationship
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Name Address City Prov Postal Code Phone # Relationship
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How did you first hear about us?
(Select one only)
    Enter Name:
     

What is the best day or date for you to make your payment? Renter's Email Address

READ STATEMENT BEFORE SUBMITTING:
I promise that the information I have provided on this rental order form is correct. I authorize Rental City to completely verfiy all information that I have provided. Rental City has my express authorization to contact any person, landlord, employer or credit reporting agency through the use of any infromation provided on this rental order form. This form is an application to rent and may be rejected if I fail to qualify or if any information I provided is found to be false.
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Date Applicant Co-Applicant
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Why Choose Rental City?

120 Day’s Same As Cash
 Free Service
 Free Same Day Delivery No Credit Checks
 No Banks Or Finance Companies No Down Payments
 No Long Term Obligation Quality Brand Names
 Preferred Customer Club Points Flexible Payment Options
High Touch, Inc.