Reference number : #

Name of owner investigating you :
Email of owner investigating you :
Rental address: , ,  
Produce report in :

First name :

Last name :

Address of the potential tenant:
 
 
 
 

Date of birth of the potential tenant:
 

Telephone number of the potential tenant:
 

Number of occupants of the premises?
adult(s):
children(s):

PART C :

Previous address:

The potential tenant authorizes Oligny & Thibodeau Investigation Services Inc. and the owner identified above to obtain all necessary information from his financial
institution, credit bureaus or other sources in order to establish his solvency. He also authorizes to check his criminal record and to communicate any information
about his credit experience to all lenders, credit bureaus and any other service provider, for the duration of the contract with the owner identified above. He solemnly affirms,
in accordance with the provisions of the Evidence Act, that all of the information identified in this form is true, including his address and date
of birth. I understand that any false declaration is subject to judicial sanctions. The tenant will be able to consult and correct the obtained report if necessary.