Application

I declare that all the below information is true and correct and the information may be used by the landlord or his agent to

verify and obtain a complete consumer credit report for purposes of this rental application. I accept that this information is

not privileged and may be used by the landlord or his agent to decide whether to accept or decline this rental application.

I understand and agree that any false or incomplete information supplied may be grounds for rejecting this application and

will violate any rental agreement following this application if discovered later.

I further grant permission to have a criminal history check done on my person.

If application is approved, all monies submitted with this application in excess of the $55 Application Fee would be held

as Earnest Money to be credited toward the rental amount at the time the Rental Agreement is executed. If, for any

reason, the applicant withdraws the application, the Landlord will retain the $55 Application Fee. If the rental property

is held for the applicant in excess of (24) hours, all monies submitted will be forfeited to the Landlord.

The applicant further understands that by clicking the submit button this shall serve as an authorization to release all

parties to provide and obtain whatever information, and to make whatever inquires deemed necessary to verify any

and all information submitted for the assessment of rental qualification.

*Certain properties will allow (1) pet under 20lbs. with an additional non-refundable pet fee of $300.00.

* Required information.

Propety Interested In: *
Desired date of occupancy: *
Desired term of lease: *
Applicant's Full Name: *
Date of birth: *
Social Security #: *
Marital Status *
Number of adults to occupy: *
Number of Children to occupy (18 and under): *
Telephone # *
Alternate Phone #
Current Street Address: *
Current City: *
Current State: *
Current Zip: *
How Long at current address? *
Current lease expiration date: *
Current Monthly Rental? *
Current Landlord? *
Current Landlord Contact # *
Occupation? *
Current Employer: *
Current Employer Phone # *
Monthly net income: *
How long with current employer? *
Co-Applicant full name:
Co-Applicant date of birth:
Co-Applicant Social Security #:
Co-Applicant Current Employer:
Co-Applicant current employer phone #
Co-Applicant monthly net income:
Co-Applicant how long with current employer?
Number of pets:
Emergency Contact Name: *
Emergency contact phone #: *
How many vehicles owned by applicant: *
Make and year of primary vehicle:
License number of primary vehicle: