Rental request

Please complete this form to make your rental request.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Information about the apartment visited

Address*

Apt.

City*

# of rooms

Terms (months)

Period (From)

Period (To)

Rent (per month)*

Number of occupants

Indoor parking ($)

Outdoor parking ($)

Electricity

Heating

Hot water

Stove/fridge

Source

Personal information

Tenet

Mr.

Mrs.

First name*

Last name*

Email*

Telephone*

Birthdate*

Address*

Street address City Postal code

Landlord

Landlord's telephone

Since when

Employer

Address

Occupation

How long

Salary (per month)*

Employer's telephone

Files

For proof of income and other documents

Drop files here or

Max. file size: 1 GB.

I am represented by a broker

Yes

Broker's name*

First Name Last Name

Broker's Email*

I, hereby, declare that above noted particulars are truthful and I authorize Immomarketing Inc. and its representatives to obtain or exchange at all times personal informations with any personal information agent for the purposes of establishing or verifying my financial standing.

Signature*

I authorize Immomarketing inc. to contact me via this email address.

Signed on*

Tenant*

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