Security Deposit of: [
Full Name : [
Area Code/Phone: [
Additional
Phones: [
Your E-mail: [
Date of Birth : [
Social Security #: [
Co Applicant
Name : [
Names of Dependents: [
Co Applicant Social Security #: [
Co Applicant
Date of Birth :
[
Dependents
Date of Birth : [
Pets are
allowed with deposit, $200/pet. No food shall be placed
outside on property to allow access to stray animals
PLEASE
GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address: [
Apt. # : [
City: [
State: [
Zip: [
Month/Year Moved In: [
Reason For Leaving: [
Rent $: [
Owner/Agent: [
Phone: [
Previous Address (Last 3 Years): [
Rent $: [
Owner/Agent: [
Rent $:[
Phone: [
PLEASE DESCRIBE YOUR
CREDIT HISTORY
Have you declared bankruptcy in
the past seven (7) Years?: [
No
Yes
Have you been evicted from a
rental residence?: [
No
Yes
Have you had two or more late
rental payments in the past Year?: [
No
Yes
Have you ever willfully or
intentionally refused to pay rent when due?: [
No
Yes
Your Employment Status: [
-----Select One-----
Full Time
Part Time
Student
Unemployed
Employer: [
Address: [
Dates Employed: [
Employed As: [
Supervisor Name: [
Work Phone: [
Salary $: [
Per: [
-----Select One-----
Hour
Week
Month
year
If employed by above less than
12 months, give name & Phone of previous employer or school: [
If you have
other sources of income that you would like us to consider,
please list income, source, and person (banker, employer, etc.)
who we may contact for confirmation. You do not have to
reveal alimony, child support, or spouse's annual income unless
you want us to consider it in this application.
Amount $ : [
Source/Contact Name: [
PLEASE LIST YOUR
REFERENCES
BANK ACCOUNTS Name: [
Type of
Account : [
Account Number : [
Bank Accounts
Name: [
Type of
Account : [
Account Number : [
Bank Accounts
Name: [
Type of
Account : [
Account Number : [
Personal
Reference or Emergency Contact Name : [
Address: [
Phone: [
Relationship: [
Your Driver's License Number: [
State : [
Vehicle(s)
Information Make/Model : [
Year: [
State License Plate: [
Vehicle(s)
Information Make/Model : [
Year: [
State License Plate: [
ADDITIONAL INFORMATION: [
Please give any additional
information that might help owner/management evaluate this
application?:[
Where may we reach you to
discuss your application? Day Phone: [
Night Phone:[
I hereby apply
to lease the above described premises for the term and upon the
set conditions above set forth and agree that the rental
is to be payable the first day of each month in advance. I
warrant that all statements above set forth are true;
however, should any statement made above be a misrepresentation
or not a true statement of facts, any deposits will be
retained to offset the agent's cost, time, and effort in
processing my application.
When so
approved and accepted, I agree to execute a lease for 12 months
before possession is given and to pay the security deposit prior
to the move in date. I recognize that as a part of your
procedure for processing my application, an investigative
consumer report to include credit agencies and criminal
background and personal interviews with others with whom I may
be acquainted will be performed. This inquiry includes
information as to my character, general reputation personal
characteristics and mode of living.
I have been made aware
that the application fee of $20 per applicant for this
investigation is payable with the submission of this application
The above
information, to the best of my knowledge, is true and correct.
Name of Applicant: [
Date: [
I agree to
permit an investigation of my credit, tenant history, banking
and employment for the purposes of renting
with this owner/manager