Please fill out all information
requested and bring the application with you to the house or email it back to me. The
application will NOT be considered unless it is filled out COMPLETELY.
NAME:
SOC. SEC. #:
DRIVERS LIC. #:
DATE OF BIRTH
ADDRESS:
(city)
(state) (zip)
PHONE #S: WORK
HOME
Car Make
YR
Model
Plate#
WHAT IS THE DATE YOU
WISH TO MOVE IN?
Housing Information
How long have you lived
at current address? From
to
Rent Amount Paid:
Name of Current Landlord:
PHONE #:
What did you like about living at this residence?
What didn’t you like about living at this residence?
How long at previous address? From
to
Name of previous landlord:
PHONE
#:
Occupation Information
Current Employment:
(name of Company)
(dates from / to)
(address)
(phone #)
(supervisors name )
(monthly income)
Prior Employment:
(name of Company)
(dates worked from/to)
(address)
(phone #)
(supervisors name )
(monthly income)
Credit References
Banks (list name of
bank, address, phone #s, Account type: checking or savings)
Credit (list name of
revolving accounts, credit cards, etc, address, phone #, type of account)
History
- Have you ever filed a petition for bankruptcy? Y N
- Have you ever been evicted from a rental property? Y N
- Have you ever been arrested? Y N
- Have you ever been convicted of a crime? Y N
- Have you ever willingly withheld rent when due? Y N
Give explanation of
any yes answer above:
Character References
(list at least two UNRELATED people who can attest to your character – give relationship and phone number)
I declare that the
information given in this application is true, and that any misrepresentation by me will be grounds for terminating any future
rental agreement entered into on the basis of this information. I further give
permission for the person or persons receiving this application to make contact with persons I have listed as references and
verify any information herein provided. I further give permission for a credit
check to be made of my file in any credit bureau.
Applicant Signature
& Date
Print Name
House Manager
(signed)
(date)
(time)
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