Online Rental Application

Please complete the form with as much information as possible. Please ensure you have completed all the required information. All information is securely encrypted and kept strictly confidential.

 Personal and Contact Information

Application Type: Applicant Co-Applicant Guarantor
First Name: *
Middle Name:
Last Name: *
Address: *
E-mail: *

Home Phone:

*
Work Phone:
Cell/Other Phone:
Date of Birth: *
Marial Status:
Smoker:
Current Rent: *
Length of Tenancy:
Landlord's Name:
Landlord's Phone:
Reason for Leaving:
   

Previous Residential Information (if less than 2 years)

 
Address:

Parish:

Zip Code:

Length of Tenancy:
Landlord's Name:
Landlord's Phone:
Reason for Leaving:
   

Rental Property Information (the property you are applying for)

   

Preferred Move-In Date:

*

Rental Lease Amount:

$ *

Preferred Lease Term:

*
Address:

*

Parish:

*

Zip Code:

*
 

Present Employment Verification

 
Employment Status:

Occupation:

*
Employer Name: *
How Long: years               months*
Current Gross Income: $ *
Name of Supervisor:
Phone: *
Street: *

Parish:

*
Zip: *
   

Previous Employment Verification

 

Occupation:

Employer Name:
How Long: years
Name of Supervisor:
Phone:
   
Personal References
  Reference

Full Name:

*

Phone:

*

E-mail Address:

Additional Questions

Have you ever been convicted of a felony
If yes, please explain:
Do you have any outstanding debts at Bermuda Credit Association or Bermuda Debt Collections?
If yes, please explain:
Will you be applying for housing allowance or social assistance?
If yes, please explain:
Have you ever been evicted?
If yes, please describe:
Do you have any pets?
If yes, please describe:
 

Type the characters from the image above:

 

I understand and hereby authorize agent/owner and any consumer or credit reporting agency or bureau employed by it to investigate criminal background, credit history, financial responsibility, ability to pay rent, employment, residential history and the information provided with this application, and to inquire and check with the persons and references named herein. This application shall become a part of any lease for this unit.

You must check this box to indicate that you read and agree to the above terms.