Mil~ A

Ontario Rul Eatn

~ Associltio■
Rentai Application
Residential
Form 410
for uM in the Province of Onlario

1/Weherebymokeopplicotionlorent ....... ~....~ :!:. ...... fu..:..~ .... ..... ... . ...... . . ..............i{ ···.. ··············································
lrom the ...... .9.L.............. doyof ....!::!."!.'::?............................ 20l ~ ...... oto monthlyrenlol of$.......-?.~ ......................................................
to beeofne due and payable in odvonce on the ...................................... doy of eoch and every month during my lenoncy.

1. Applcant tl ... J.iA.~.~J..~~..~.~~f .....~./~~}'!:!:Dote of birth ...J. ~./?,~/!C....SIN No. (OplionoQ ..................................... ....
. h IJA N Cl,t L ltdvïr of? lff {É'B€f!ll'l (;;o V.
Dri\19r$ License No ......................................................... Occupation ........................................... ••••.... •............ •••.......••••••••.. ••••· •.. ·············

2. Applicant 12 .................................................................. Dote of birth .............................. SIN No. (OptionoQ ........................................ ..

Dri_.s License No ......................................................... Occupation ........... .. •...................... •.............. •...................... ·.. ··................. ·.... ·.. ·

3, Other Occupanlm Nome ............................................................................ Relotionship ............................................. Age .................. .

Nome ............................................................................ Relotionship ............................................ • Age •.............. •.. ..

Nome ............................................................................ Relotionship ................................ •••....... ••• Age •........ •••••••••••

Do you have ony petsî .....':!./!:'!. ......... If so, describe ................................................................................................................................. .

Î O S/'111-Ll
Wtry ore you vocoting your present place of residence? ............................................................................................................. ·................. ·

APPUCAN1' 11 LA5T 1WO PLACES OF RESIDENCE APPUCANI' 12 lAST 1WO PLACES OF RlSIDENCE

Pr-.t Address .&iJ......w.. . .,J..t.~ ...VR!.1, ~................... .. Pr...rAddress ................................................................................. .

...~~~~... . . !..0... Y.~..f .................................... ......... ·········································································································

0!<:::f...1-..~.?;P..................... To .....!f/ !!.............................
From .•:•. Frorn ............................................... 1o .............................................

Nome of Londlord ................ N.( ft................................................... Nome of Londlord ............................................................................ ..

Telephone: ...................................................................................... .. Telephone: .........................................................................................

Prior.Addr.. .................................................................................... Prior~ .................................................................................... .

From ............................................... To ............................................ Frorn ............................................... lo ........................................... ..

Nome of Landlord ............................................................................. Norne of londlord ..............................................................................

Telephone: ........................................................................................ Telephone: .........................................................................................

APPUCANT 11 PRESENT EMPLOYMENT APPUCANI' 12 PRESENT EMPLOYMINT

Employer ............ ~ .JX:.~.~L.....b..Q..@..N}:!~7'!.:L ................... Employer ...........................................................................................

Business oddress .. /.0..?.....~.C!f...t.t !i.~ .?:-:..\L~.;SIJ!.!.~ ~. Business oddress ............................................................................... .

Business lelephone ... }.~.?..'::. .. ~~(q,.:::..f.Y.Y.l. ............................ Business lelephone ........................................................................... .

Position (;rJ Ir tJ CI/t1.. ,r{) -VIJ ~

.. held ..................................................................................... Position held .................................................................................... .

1.ength of employment .......... f ..'.:j~~............................................ Length of employment ......................................................................... .

• WOJ'}A_ Y.IN
N0 me of superv1sor ....................:...................................................... Norne of supervisor ......................................................................... ..

Current solory ronge: Monthly $ ...... 2. !. ~.~... . C~.~J.. . . ... . Current solory ronge: ~thly $ ......................................................... ..
m
UJ
The irodemo-b RfAIJ'~ REAIJ'OiSe, MLSe, M,J!iJll! Listing ~ and ossoclallld logoo 0 1'1 owned Of conlrolled by
The Conodion Raol fslolt ~ 10ŒA1 and ldentify the rool - pn,l,,s.ionols who oro _,ce,s of CREA ond the
- - quolity ol ..w:. i-r f"O'Ïde. UNd Ünder ne-..
!1) ~ 23, q,,torio~fslolt~rOREA1.Al rig/111.~ .'IJ,•lçnnwos~ by OREAfor~~-~-repn,d~