Apply "*" indicates required fields Do you live in: Greater Victoria, Sooke or Langford?* Yes No We’re sorry, but if you’re reading this you are not within our delivery area and we are unable to rent product to you. You MUST live in the South Vancouver Island area. PERSONAL INFORMATIONName* First Middle Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code How long at residenceYears*Months*How much is your rent?*Landlord’s Name* Landlord’s phone #*Email* Phone*Birthdate* MM slash DD slash YYYY Sin#* ID # (DL or other gov’t ID)* Status # Source of Income *All fields in this section are required except for employer contact information.My Primary Source of Income Is:*EmployedSelf EmployedCanada Pension Plan (CPP)Employment Insurance (EI)Child Tax Benefit (CTB)Workers Compensation (WCB)Social AssistanceOtherOther* Last Net Pay (Take home pay)*Do you or your spouse that lives with you receive Child Tax Benefit?* Yes No How much is your Child Tax benefit? I get paid by*Direct DepositChequeCashHow often do you get paid?*WeeklyEvery 2 weeks15th & EndTwice per monthMonthlyNext Pay Date* MM slash DD slash YYYY Second Pay Date* MM slash DD slash YYYY Employer Name* Name of boss* Name Business Phone*Your Direct Phone LinePosition* How long at jobYears*Months* Do you live with your spouse / partner?* Yes No Partner InformationSpouse / Partner First Name* Spouse / Partner Last Name* Name they go by Birthdate* MM slash DD slash YYYY SIN# Cell #*Email* Employer or Source of Income* Work #Direct Line #Position Net Pay each Payday* References 4 references, FIRST & LAST name. Minimum of two family members.Name* First Last Relation*ParentBrother / SisterChildFriendAunt / UncleOther FamilyRoommatePhone*Does this person live with you?* Yes No Name* First Last Relation*Brother / SisterFriendParentChildAunt / UncleOther FamilyRoommatePhone*Does this person live with you?* Yes No Name* First Last Relation*RoommateFriendParentBrother / SisterChildAunt / UncleOther FamilyPhone*Does this person live with you?* Yes No Name* First Last Relation*FriendParentBrother / SisterChildAunt / UncleOther FamilyRoommatePhone*Does this person live with you?* Yes No Banking Information *All fields in this section are required My bank account is with* 3 Digit Institution #* 5 Digit Institution #* Account #* Confirm account #* We take pre-authorized payments through your bank with your bank card # please fill out the following:Bank Card Number* Expiry* MM slash DD slash YYYY CVV Documentation You can significantly speed up the processing time of your application by uploading the following documents. We will not start processing your application until these have been uploaded. If you don’t have them now, you can email them to sales@freedomrto.ca Proof of Address:Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 32 MB.A utility bill dated in the last 30 days, or your ICBC insurance documents.Identification:Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 32 MB.Government issued picture ID, preferably Drives LicensePaystub:Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 32 MB.Attach your recent paystub or pay statement from a private pension. Note: we do NOT need proof of CPP or CTB benefit.Child Tax Benefit:Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 32 MB.Attach your CCB Notice detailing the amount of your monthly CTB Other InformationIf we have any questions, where should we call you between 10 am – 6 pm PST time? Include area code.*Products you are interest in*By checking the box and clicking “Submit”, you consent to Freedom RTO’s collection, use, and disclosure of your personal information as described in our Privacy Policy.* I agree Promo Code? Yes No Please input your promotional code