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Application for Rooms for Rent


Today's date

What is your birthdate?

Your contact information: phone number and/ or email address.

Reference: Name, Phone number and relationship to you.

Where do you currently live (address)?

How long have you lived at this address?

Who is your landlord? and what is his/ her phone number?

What is your current source of income? If employed, list employer.

what is your monthly income?

By checking the boxes below, I acknowledge that I have read and understood that there are a few rules that I am willing to abide by if accepted:

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