Application Applicant Applicant Name * Applicant Name First First Last Last Birthdate MM/DD/YY * Present Address * Home Phone Work Phone Cell Phone Email * Section Buttons Co-Applicant Name Name First First Last Last Birthdate MM/DD/YY Present Address Home Phone Work Phone Cell Phone Email Section Buttons Applicant Employment Information Applicant Occupation * Applicant Current Employer * Applicant Employer Phone * Applicant Years Employed * Employment Income Applicant Other Income * Applicant Previous Employer * Applicant Previous Employer Phone * Section Buttons Co-applicant Employer Information Co-Applicant Occupation Co-Applicant Current Employer Current Employer Phone Years Employed Employment Income Other Income Previous Employer Previous Employer Phone Section Buttons Applicant Landlord Information Present Landlord's Name Landlords Address Phone How long have you lived there? Reason for moving? Previous Landlord's Name Previous Address Previous Landlord's Phone Section Buttons Co-Applicant Landlord Information Present Landlord's Name Present Landlord's Address Present Landlord's Phone How Long have you lived there? Reason for moving Previous Landlord's Name Previous Landlord's Address Previous Landlord's Phone Section Buttons Next Of Kin Applicant Next of Kin Name Applicant Next of Kin Name First First Last Last Phone Co-Applicant Next of Kin Name Co-Applicant Next of Kin Name First First Last Last Phone Section Buttons Date Applicant Signature Date Co-Applicant Signature The undersigned hereby represents and warrants that all the information provided herein and on any accompanying applications or statements is true, complete and correct. It is understood that the information provided may be fully researched and relied upon by the Residences at Queen’s Marque Limited or any of its affiliates or subsidiaries. The undersigned further expressly consents to the Residences at Queen’s Marque Limited or any of its affiliates or subsidiaries using and disclosing the personal information contained or referenced herein to make any inquiries it deems necessary to fully research this application including inquiries of any credit reporting agency. I/We consent to the collection, use and disclosure at any time of the credit information about me/us to any credit agency or to anyone with whom I/we have financial relations. I expressly consent to the Residences at Queen’s Marque Limited or any of its affiliates or subsidiaries sending me commercial electronic messages related to my tenancy. I/We may revoke consent by contacting (902) 422-4424. For the purposes of this consent the Residences at Queen’s Marque Limited or any of its affiliates or subsidiaries includes its assigns. If you are human, leave this field blank. Submit
