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Monday, September 04, 2006

Residential Rental Application

RESIDENTIAL RENTAL APPLICATION
NON-REFUNDABLE $20 Application Fee PER PERSON

( Each adult to complete separate application. All persons over 18 must be on lease and complete an application prior to signing lease.). Please complete and return to:

Landlords Name
Address
Phone


Please print clearly

1. Name of Applicant_____________________________ Phone_____________

Present Address_____________________________________________________

How Long There?____________________ S.S. Number________-____-_______
If at above address for less than 5 years please complete below. Add additional sheet if needed for all landlords for past 5 years.
Present Landlord________________________________Phone_______________
Monthly Rent____________Reason for Leaving____________________________

2. Priort Landlord______________________________ Phone_____________

Address_____________________________________________________________

Monthly Rent________________________ How Long there___________________
Reason for Leaving_____________

3. Previous Landlord_____________________________ Phone_____________

Address_____________________________________________________________

Monthly Rent____________________________How Long There?_____________

Reason for Leaving__________________________________________________


4. Full names of all individuals (and ages of all children) who will be occupying premises_______________________________________________
Please use additional sheet if required.


5. Pets (specify)___________________________________________________


6. Have you ever been evicted, sued for nonpayment of rent, or

breached a lease (if so, explain)?__________________________________


7. Present Employer______________________________ Phone_____________

Address______________________________________Occupation_____________

Gross Monthly Salary_______________Length of Employment_____________


8. Previous Employer_____________________________ Phone_____________

Address______________________________________Occupation_____________

Gross Monthly Salary_______________Length of Employment_____________
If less than 2 years please use additional sheet.

9. Other Income, if any (specify source)____________________________


10. Bank-Checking Account_____________________Account Number________

Address____________________________Approximate Balance______________


11. Bank-Savings Account______________________Account Number________

Address____________________________Approximate Balance______________


13. Credit Cards:

(1)_________________Bank___________________Card Number______________

(2)_________________Bank___________________Card Number______________

(3)_________________Bank___________________Card Number______________
Please use additional sheet if required.






14. Loans:

(1)Lender______________________________________Balance______________

Address________________________________Monthly Payment______________

(2)Lender______________________________________Balance______________

Address________________________________Monthly Payment______________
Please use additional sheet if required.

15. Other Debts and Obligations, if any (specify)___________________

16. Personal Reference___________________________ Phone_____________

Address_____________________________________________________________

17. Automobiles:

Your License Number________________________________________State____

(1)Make/Model______________Year___________Plate____________State____

(2)Make/Model______________Year___________Plate____________State____


18. In case of emergency notify_____________________________________

Address__________________________________________ Phone_____________

19. Do you or a family member smoke?

20. Have you ever been arrested or convicted for a drug related charge?

I certify that the above information is true and complete. I authorize the verification of this information and complete credit, criminal background check by contacting any or all individuals, state or government agencies and financial institutions listed above. I understand that this is not a lease or an offer to rent. No binding obligation of any kind exists between the owner and myself unless and until a lease is signed. This Application is subject to prior Applications. This Application shall remain the property of the owner.



Signature of Applicant________________________________Date__________

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