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RENTAL APPLICATION

Type and Size unit desired________________________________________________________

Desired date of occupancy_____________ Desired length of occupancy_______________

APPLICANT INFORMATION :

Name____________________________ Phone___________ Cell___________ Pager___________

Address___________________________________________ State_________ Zip_____________

How long at current address______ Rent_______ Date in-_________ Date out__________

Reason for leaving current address________________________________________________

Landlord's Name & Company________________________________________ Phone___________

Landlord's Address________________________________________________________________

Married____ Single____ Divorced____ Legally Separated____ if so how long?_________

D.L. # & State________________ S.S. #___________________ Date of birth____________

Employment __________________________________________How long employed?___________

Employer's Address________________________________________________________________

Salary (Take Home Pay)_______ (Weekly / Bi-Weekly / Monthly) Position_____________

Name of Supervisor__________________________________ Supervisor Phone_____________

Other Income (Alimony, Child Support, S. S., Retirement, Welfare, Other )$________

Credit References:

References Name Address/Phone Purpose & payment amount account status

__________________________________________________________________________________

Personal References:

References Name Address Phone Relationship

__________________________________________________________________________________

CO-APPLICANT INFORMATION :

Name______________________________ Phone___________ Cell__________ Pager__________

Address________________________________________________ State_______ Zip__________

How long at current address?_________ Rent_______ Date in________ Date out________

Reason for leaving current address________________________________________________

Married____ Single____ Divorced____ Legally Separated____ if so how long?_________

D.L. # & State___________________ S.S. #_____________________ Date ofbirth________

Employment_______________________________________________How long employed?_______

Employer's Address________________________________________________________________

Salary (Take Home Pay)_______ (Weekly, Bi-Weekly / Monthly) Position______________

Name of Supervisor ________________________________Supervisor Phone_______________

Other Income (Alimony, Child Support, S. S., Retirement, Welfare, Other)__________

Credit References:

Name Address/Phone Purpose & payment amount account Status

__________________________________________________________________________________

Personal References:

Name Address Phone Relationship

__________________________________________________________________________________

______________________________________________________________________

OTHER TENANTS:

ALL OTHER PERSONS WHO WILL OCCUPY THIS APARTMENT WITH YOU:

Name______________________________Relationship_______________Age_______ Sex_______

__________________________________________________________________________________

VEHICLES;

LIST ALL VEHICLES THAT WILL BE KEPT ON THE PROPERTY

Type( car/truck) color year make model license plate number & state

__________________________________________________________________________________

GENERAL INFORMATION:

Do you own any pets? ( ) yes ( ) no, If yes what kind and description_____________

Have you ever been evicted? ( ) yes ( ) no

Have you ever willfully and intentionally refused to pay rent when due?( )yes( )no

Do you know anything which may interrupt income or ability to pay rent?( )yes( )no

Have you ever broken, or in any manner failed to honor

a lease or rental agreement?( ) yes ( ) no. If yes

please explain:___________________________________________________________________

Have you or your co-tenants ever been

arrested and convicted of a Felony? ( ) yes ( ) no

If yes please explain:____________________________________________________________

Have you ever applied for a rental unit with us before?( )yes( )no

If yes,when?______________________________

How were you referred to us? ( ) saw sign ( ) newspaper ad ( ) friend ( )

other explain___________________________

IN CASE OF EMERGENCY CONTACTS: List contacts for each tenant

Name Address Phone Relationship

__________________________________________________________________________________

We declare the above information to be true and that the Owner/Management or Agent may immediately terminate any tenancy entered into in reliance upon misinformation given on this application and shall result in full loss of security deposit. The Applicants authorize the Owner/Management or his agent to investigate information regarding my character, general reputation, personal character references, mode of living, credit standing history and a full disclosure of pertinent facts may be made to the Owner/Management or Agent. The Applicants authorize the Owner/Management or Agent to obtain information from Law Enforcement Agencies in regards to a full criminal background history check. The applicants authorize full disclosure. There shall be a $20.00 Non-refundable Application Fee regardless if your accepted or rejected to lease from us.

APPLICANT SIGNATURE__________________________________________ DATE_____________

CO-APPLICANT SIGNATURE_______________________________________ DATE_____________