Emergency Contact & Tenant Information Sheet

THIS FORM IS FOR RESIDENTIAL TENANTS ONLY.

Please note that shaded fields are required to process your application.

Please fill in ALL fields, if a field doesn't apply please enter: N/A.

SECTION A.

Rental Unit Details

Suite: Building Address:

Storage Number:	Parking Stall:

Vehicle Details

Do you have a vehicle? Yes: No:

Vehicle Make/Model:	Vehicle Colour:	Vehicle License:

SECTION B.

Tenant Information

For insurance reasons we MUST have the names of all people living in the unit. If occupants are under age 18 their ages must be submitted.

Tenant Name:	Age:

Tenant Name:	Age:

Tenant Name:	Age:

Tenant Name:	Age:

Primary Contact

Home Phone:	Work Phone:

Cell Phone:	Email Address:

SECTION C.

Emergency Contact

In case of emergency only, please provide contact information of someone not living in the unit.

Name:	Relationship:

Cell Phone:	Work Phone:

Please indicate any particular conditions (ie: mobility problems, hearing or sight problems) that the authorities should be made aware of in case of an emergency:

SECTION D.

Tenant Insurance

Insurance Company: Policy Number:

Hard Copy submitted to the Office: Yes: No:

Please enter what you see in the image above: