House Rental Application Form

PERSONAL INFORMATION

Full Name: francisco chong

Mobile Number: ___650 686 7763

Home Number: ____________________

Email Address: fjchong@gmail.com

Current Address: 211 aspen south san francisco ca

Duration of Stay at Current Address: _25 Months

Current Landlord Name: _jose lius ramirez

Current Landlord Number: (650) 455-0431

Current Landlord Address:211 aspen south san francisco ca

_______________________________________________________

RELATIONSHIP INFORMATION

Martial Status: [ x] Single [ ] Married [ ] Living with a Partner

Details of Occupants Living Together:

Relationship Age Gender

victor vargas
________________________
________________________
________________________
________________________
45 male
________________________ ________________________
________________________ ________________________
________________________ ________________________
________________________ ________________________

Profession occuption

When is your move in Date _12/30/15

How many Month can you pay to secure the house now 1
How long are you staying in My Home 12 Months

PERSONAL DECLARATION

I declare that the information that I have provided in this renters application are
true and updated to the best of my knowledge.

I hereby authorize the prospective landlord (Landlord Name:

_________________________) to carry out any background and credit checks
necessary to verify my particulars and standing.

I also authorize the prospective landlord to contact my current landlord, employer,

next of kin and other related person for references.

Important Note: Providing false information to a landlord in order to obtain a

tenancy are legal grounds for terminating that tenancy with immediate effect.

Applicant's Name: francisco chong

Applicants Signature: F Date: 19/12/2015