ALBERTA RESIDENTIAL RENTAL APPLICATION

Date of Application: [[Application Date]]

Property Address: [[Full Property Address Including Unit if Applicable]], [[City]], Alberta [[Postal Code]]

Landlord / Property Manager: [[Landlord or Property Management Company Full Name]]

Contact Phone: [[Landlord Contact Phone]]

Contact Email: [[Landlord Contact Email]]

Advertised Monthly Rent: $[[Monthly Rent Amount]]

Security Deposit (max one month's rent): $[[Security Deposit Amount]]

Pet Damage Deposit (if applicable, max one month's rent): $[[Pet Damage Deposit Amount or N/A]]

Proposed Lease Start Date: [[Lease Start Date]]

Lease Term: [[Fixed Term Length / Month-to-Month]]

Application Fee (if any): $[[Application or Screening Fee Amount or $0]] (disclosed below; Alberta has no statutory cap on application fees), -

Alberta residential tenancy relations are governed by the *Residential Tenancies Act*, S.A. 2004, c. R-17.1 (RTA) and regulations. The Real Estate Council of Alberta (RECA) provides guidance on rental practices. Landlords may charge an application or screening fee but must disclose the amount and purpose in advance. Many landlords charge $0. There is no statutory maximum fee.

All questions must comply with the *Alberta Human Rights Act*, RSA 2000, c A-25.5. Landlords may not discriminate on the basis of race, religious beliefs, colour, gender, gender identity, gender expression, physical disability, mental disability, age, ancestry, place of origin, marital status, family status, source of income, or sexual orientation.

Credit and background checks must comply with the *Personal Information Protection Act* (PIPA) and the federal *Personal Information Protection and Electronic Documents Act* (PIPEDA) where applicable. Consent must be informed and specific.

Income screening commonly uses a 2.5x to 3x rent multiplier as an objective benchmark, but the multiplier must be applied uniformly and consistently with fair-housing obligations. Source of income (including social assistance, disability benefits, or other lawful sources) is a protected ground; landlords may verify sufficiency but may not refuse on the basis of the source itself., -

1. Applicant Personal and Contact Information

*All adult occupants (18+) must submit a separate application or be listed as co-applicants.*

Full Legal Name: [[Applicant Full Legal Name]]

Date of Birth (YYYY-MM-DD): [[Date of Birth]]

Primary Phone: [[Primary Phone Number]]

Alternate Phone: [[Alternate Phone Number]]

Email Address: [[Email Address]]

Current Mailing Address: [[Current Street Address, City, Province, Postal Code]]

Length of Time at Current Address: [[Years and Months at Current Address]]

Reason for Moving: [[Reason for Leaving Current Residence]]

Government-Issued Photo ID Type and Number: [[Driver's Licence / Passport / Other ID Type and Number]]

ID Issuing Jurisdiction: [[Issuing Province or Country]]

Social Insurance Number (last four digits or full for credit check only): [[SIN Last Four or Full as Consented]]

Emergency Contact Name: [[Emergency Contact Full Name]]

Emergency Contact Relationship: [[Relationship to Applicant]]

Emergency Contact Phone: [[Emergency Contact Phone]], -

2. Residency History

*Provide at least the last three years of addresses. Attach additional sheets if needed.*

Current Residence

Address: [[Current Residence Full Address]]

Landlord / Property Manager Name: [[Current Landlord Name]]

Landlord Phone: [[Current Landlord Phone]]

Landlord Email: [[Current Landlord Email]]

Monthly Rent Paid: $[[Current Monthly Rent]]

Dates of Tenancy: [[Move In Date]] to Present

May we contact this landlord? [[Yes / No, If No, explain: [[Reason Cannot Contact Current]] ]]

Previous Residence 1

Address: [[Previous Residence 1 Full Address]]

Landlord / Property Manager Name: [[Previous Landlord 1 Name]]

Landlord Phone: [[Previous Landlord 1 Phone]]

Landlord Email: [[Previous Landlord 1 Email]]

Monthly Rent Paid: $[[Previous Monthly Rent 1]]

Dates of Tenancy: [[Start Date 1]] to [[End Date 1]]

Reason for Leaving: [[Reason for Leaving 1]]

May we contact? [[Yes / No]]

Previous Residence 2

Address: [[Previous Residence 2 Full Address]]

Landlord / Property Manager Name: [[Previous Landlord 2 Name]]

Landlord Phone: [[Previous Landlord 2 Phone]]

Landlord Email: [[Previous Landlord 2 Email]]

Monthly Rent Paid: $[[Previous Monthly Rent 2]]

Dates of Tenancy: [[Start Date 2]] to [[End Date 2]]

Reason for Leaving: [[Reason for Leaving 2]]

May we contact? [[Yes / No]]

Gaps or Additional History: [[Explain any gaps in the last three years or additional residences]]

Have you ever been evicted, had a tenancy terminated early for cause, or been asked to leave a rental? [[Yes / No]]

If yes, provide details including dates, addresses, and outcome: [[Eviction or Termination Details]], -

3. Employment and Income Verification

*Qualifying income is typically evaluated at 2.5 to 3 times the monthly rent using objective, consistently applied criteria. All lawful sources of income are considered equally under the Alberta Human Rights Act.*

Primary Employment / Income Source

Employer or Income Source Name: [[Primary Employer or Income Source Name]]

Employer Address: [[Employer Street Address, City, Alberta Postal Code]]

Position / Job Title: [[Applicant Job Title]]

Employment Type: [[Full-Time / Part-Time / Seasonal / Self-Employed / Retired / Other]]

Start Date: [[Employment Start Date]]

Gross Monthly Income (before deductions): $[[Gross Monthly Income Primary]]

Supervisor / HR Contact Name: [[Supervisor or HR Contact Name]]

Supervisor / HR Phone: [[Supervisor or HR Phone]]

May we contact for verification? [[Yes / No]]

Additional Income Sources (if used for qualification)

Source 1 Description: [[Additional Income Source 1 Description e.g. Secondary Job, Benefits, Support Payments]]

Monthly Amount: $[[Additional Monthly Amount 1]]

Documentation Available: [[Pay Stubs / Tax Returns / Award Letters / Bank Statements / Other]]

Source 2 Description (if any): [[Additional Income Source 2]]

Monthly Amount: $[[Additional Monthly Amount 2]]

Self-Employed Applicants: Provide the most recent two years of tax returns and three months of business bank statements upon request.

Income Documentation Typically Required (at minimum two):

1. Most recent pay stubs (two or more)

2. Most recent federal Notice of Assessment or tax return

3. Last three months of bank statements

4. Employment offer letter (if recently started)

5. Government benefit or pension award letter

6. Other: [[Specify Other Documentation]], -

4. Rental History and Landlord References

Reference 1 (Current or Most Recent Landlord)

Name: [[Reference 1 Landlord Full Name]]

Phone: [[Reference 1 Phone]]

Email: [[Reference 1 Email]]

Property Rented: [[Reference 1 Property Address]]

Dates of Tenancy: [[Reference 1 Start]] to [[Reference 1 End]]

Reference 2

Name: [[Reference 2 Landlord Full Name]]

Phone: [[Reference 2 Phone]]

Email: [[Reference 2 Email]]

Property Rented: [[Reference 2 Property Address]]

Dates of Tenancy: [[Reference 2 Start]] to [[Reference 2 End]]

Reference 3 (if available)

Name: [[Reference 3 Landlord Full Name]]

Phone: [[Reference 3 Phone]]

Email: [[Reference 3 Email]]

Property Rented: [[Reference 3 Property Address]]

Dates of Tenancy: [[Reference 3 Start]] to [[Reference 3 End]], -

5. Credit, Background Check, and Personal Information Consent (PIPEDA / PIPA Compliant)

NOTICE REGARDING CONSUMER REPORTS AND PERSONAL INFORMATION

In connection with this rental application, the Landlord or its authorized screening agent may obtain a consumer credit report, criminal background check, eviction history search, and employment/income verification from consumer reporting agencies and other third parties.

This collection, use, and disclosure of personal information is conducted in accordance with the *Personal Information Protection and Electronic Documents Act* (PIPEDA) and Alberta's *Personal Information Protection Act* (PIPA). Information will be used solely for evaluating this rental application and will be retained only as long as necessary or as required by law. You may request access to or correction of your personal information held by the Landlord.

Authorization and Consent

I, [[Applicant Full Legal Name]], authorize the Landlord and its screening agents to:

• Obtain and review my credit report and credit history

• Conduct criminal record and background checks (local, provincial, and national)

• Search eviction and tenancy history records

• Verify employment, income, and residency information with listed references and employers

• Contact any person or entity listed on this application for verification purposes

I understand that this authorization remains valid for the duration of the application process and any resulting tenancy screening. I consent to the disclosure of my personal information to third-party service providers for these limited purposes only.

Social Insurance Number (for credit and identity verification only): [[SIN, XXX-XXX-XXX or last four digits]]

*Providing a full SIN is voluntary but may be required by the credit reporting agency. The Landlord will protect this information in accordance with applicable privacy laws.*

Applicant Signature for Consent: _________________________________ Date: [[Consent Date]], -

6. Application / Screening Fee Disclosure

Fee Amount: $[[Application Fee Amount or $0.00]]

Purpose of Fee: [[Credit report cost / Background check cost / Administrative processing / No fee charged]]

Refundability: [[Non-refundable / Refundable only if application withdrawn before screening begins / N/A]]

The Landlord discloses this fee before requesting any consumer report. No fee is required to submit this application if the amount above is shown as $0. Payment of any fee is not a guarantee of approval., -

7. Screening Criteria (Objective and Uniformly Applied)

The Landlord applies the following objective criteria to all applicants. Meeting these criteria does not guarantee approval; the Landlord reserves the right to consider the totality of the application and references.

• Income: Gross monthly household income should equal or exceed [[2.5x / 3x]] the monthly rent (or other disclosed multiplier). All lawful sources of income are evaluated on equal terms.

• Credit History: Minimum credit score or clean report with limited negative items in the past [[X]] years. Bankruptcies and collections will be individually assessed.

• Rental History: No evictions or material lease violations in the past [[X]] years. Positive references from prior landlords required.

• Criminal Background: Convictions will be evaluated on an individualized basis consistent with fair-housing guidance, considering nature, recency, and relevance to tenancy.

• Other: [[Additional objective criteria e.g. no more than X occupants per bedroom per local bylaws, valid ID required]]

The Landlord will provide adverse action notice if screening results in denial, including the name of any consumer reporting agency used and a summary of rights., -

8. Alberta Human Rights Act, Fair Housing Notice

The *Alberta Human Rights Act* prohibits discrimination in the rental of residential premises on the following protected grounds:

1. Race

2. Religious beliefs

3. Colour

4. Gender

5. Gender identity

6. Gender expression

7. Physical disability

8. Mental disability

9. Age

10. Ancestry

11. Place of origin

12. Marital status

13. Family status

14. Source of income

15. Sexual orientation

The Landlord applies screening criteria uniformly to all applicants without regard to any protected ground. Any question on this form is intended solely to verify identity, financial qualification, or tenancy suitability and is not intended to elicit information about protected characteristics beyond what is necessary and permitted.

If you believe you have been discriminated against, you may contact the Alberta Human Rights Commission., -

9. Pets, Occupants, Vehicles, and Additional Occupants

Intended Occupants (including applicant): [[Number of Occupants]], List all adults and children who will reside: [[Full List of All Occupants Names and Ages]]

Pets (describe number, type, size, and any service/assistance animals): [[Pets Description or None]]

Vehicles (number, types, license plates if known): [[Vehicle 1 Description]] ; [[Vehicle 2 Description or None]]

Smoking Policy Preference / Disclosure: [[Non-smoking / Smoking permitted outdoors only / Other: [[Specify]] ]]

Additional Notes or Requests: [[Any special accommodations or additional information]], -

10. Declarations and Signature

I declare that the information provided in this application is true, accurate, and complete to the best of my knowledge. I understand that any material misrepresentation may result in rejection of this application or termination of any tenancy granted.

I acknowledge that I have received a copy of this application form and the fee disclosure (if any) prior to signing.

Applicant Printed Name: [[Applicant Full Legal Name]]

Applicant Signature: ________________________________________

Date: [[Signature Date]]

Co-Applicant Printed Name (if applicable): [[Co-Applicant Full Legal Name]]

Co-Applicant Signature: ________________________________________

Date: [[Co-Applicant Signature Date]]

Landlord / Agent Acknowledgment of Receipt:

Printed Name: [[Landlord Agent Printed Name]]

Signature: ________________________________________ Date: [[Receipt Date]], -

*This is a template rental application form for use in Alberta. It is designed to collect permissible information in compliance with the Residential Tenancies Act, Alberta Human Rights Act, PIPA, and PIPEDA. Landlords remain responsible for ensuring their screening practices and forms are current and legally compliant at the time of use. No application fee is mandatory; any fee charged must be disclosed. This template is not legal advice. Consult RECA guidance, the Residential Tenancy Dispute Resolution Service, or a qualified Alberta lawyer for jurisdiction-specific requirements. "Unknown" or non-applicable responses are acceptable where the applicant lacks information.*

> ⚠️ Template example, not professional (legal/financial/medical) advice. All user-supplied values use [[Token Name]] format. Verify current RECA and RTA requirements before use. Confirm all protected grounds and privacy obligations at time of deployment. Content current as of June 2026.

Sources (as of June 2026):

• Residential Tenancies Act, S.A. 2004, c. R-17.1 (RTA)
• Alberta Human Rights Act, RSA 2000, c A-25.5
• Personal Information Protection Act (Alberta PIPA)
• Personal Information Protection and Electronic Documents Act (PIPEDA)
• Real Estate Council of Alberta (RECA) rental practice guidance
• Residential Tenancy Dispute Resolution Service (RTDRS) information