I, the undersigned, will hereby tender a rental deposit, in the amount indicated below, and submit this as an application and offer to lease:

  • Each Applicant must complete a separate application
  • Once approved, you will forfeit some or all of your deposit if you do not proceed with renting the premises
  • Absolutely No Pets Allowed

I understand that this application is subject to the approval of Sussex Realty (as agents for the Landlord) and that the deposit will be returned in full if the application is not accepted. This application form, once submitted, shall remain the property of Sussex Realty and will not be returned. I also understand that once this application has been approved, this deposit may be retained, as liquidated damages should we fail to proceed to lease the below unit. I understand that the unit is offered for rent in good faith and in the belief that the unit will be vacant and in suitable condition on the intended date of possession. I acknowledge that the Landlord and its agent will not be responsible or liable to the applicant, other than the abatement of rent, should the unit not be vacated or in suitable condition on the intended date of possession.

NOTE: Parking is subject to availability and may be re-assigned at the Landlord’s discretion.

Rental Application


Present Address

Previous Address

Present Employment

Other Employment

Other Occupants

Emergency Contact


I hereby affirm the above information to be true in every respect. I authorize Sussex Realty to contact any current or previous Landlord as well as the employers, references and others listed above to confirm this information. I hereby authorize disclosure of my personal information in regards to the Employment Income Assistance Program of the Department of Family Services and Housing. I acknowledge that Sussex Realty will obtain a copy of my credit history. In signing this application, I hereby consent to the use or disclosure of the personal information contained in this application for the purposes stated in the Sussex Realty Privacy Policy.