Rental Application     

Please complete all the information below. All applicants over the age of 18 must complete and sign their own application.

Applicant's full name____________________________Phone #______________DOB___________

Social Security #_______________Driver's License #______________State_______Exp._________

Current Address________________________________City________________State____Zip___________

Current Landlord's Name___________________________Landlord's Phone #__________________

How long at this address______Reason for leaving________________________________________

Previous Address________________________________City_________________State____Zip__________

Previous Landlord's Name__________________________________Phone #__________________

How long at this address________Reason for leaving______________________________________

Auto Yr______Make_________Model_______________State/License Plate #_________________

Present Employer________________________Position_________________Mo. Income_________

Phone #______________How long at job__________

Other income/source___________________________

Employer's Address_________________________________________Supervisor_______________________

Have you ever been party to an eviction? [ ] Yes  [ ] No

Ever filed for bankruptcy?_________________________ When?____________________________

Ever been convicted of a felony?  [ ] Yes  [ ] No

Name of bank______________________Branch____________Type of Account________________

Name of bank______________________Branch____________Type of Account________________

Personal References

Name____________________Yrs. Known_____Relationship____________Phone  #____________

Name____________________Yrs. Known_____Relationship____________Phone  #____________

Name____________________Yrs. Known_____Relationship____________Phone  #____________

Name and relations of all other applicants _______________________________________________

Total adults______Total children living with you under the age of 18______

Contact in Emergency _________________Address_____________________Phone  #___________

Do any applicants or dependants smoke? [ ] Yes  [ ] No

Type of pets and number of each type__________________________________________________

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for tenant screening as may be necessary in arriving at a tenant decision, I understand that the landlord may terminate any rental agreement entered into for any misrepresentations made above.

Signature_________________________________________________Date___________________

Received from applicant the non-refundable sum of $__________________dollars to pay for tenant screening service and credit check..