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Rental Reference Request Form

Rental Reference Request Form

Primary Applicant:
Secondary Applicant:

Dear Sir/Madam:
I/we have applied to Champagne and Aishihik First Nations for a rental housing unit and are required to provide confirmation of our tenancy record. Please complete the following:

Landlord Name:

Date applicant rented:

DD slash MM slash YYYY
DD slash MM slash YYYY
Address of rental property:
Did the applicant give the required notice prior to vacating the unit?
Did the applicant maintain the unit according to the terms of the lease agreement?
Did the applicant commit any breach of the lease/rental agreement?
Was the rent paid each month, by the due date?
Is there a balance owing for rent, damage or other charges?
Clear Signature
DD slash MM slash YYYY
Consent
Clear Signature
DD slash MM slash YYYY
Clear Signature
DD slash MM slash YYYY

CAFN USE ONLY

MM slash DD slash YYYY