RENTAL APPLICATION

PROPERW ADDRESS MOVE.IN DATE

Name (Last, First, M.l.) Birth date Drivers License Number & State

Sociaf Security Number Automobile Make Model & Year License Number & State

Spouse's Name (Last, First, M.l. Birth date Spouse's Drivers Lic. Number & State

Spouse's SSN# Spouse's Auto Make Model & Year License Number & State

Present Adclress City, State, Zip How Long? Area Code & Number

Present Landlord Landlord Address Rental Rate Landlord Phone Number

Previous Address (lf less than 2 years) Previous Landlord Landlord Phone Number

Applicant Employed By Employefs Adclress Employe/s Phone Number

How Long? Department Position Supervisor Salary (Gross)

Previous Employer Previous Employe/s Address Prev. Emp. Phone Number

Spouse Employed By Spouse Employels Adclress Spouse Employels Phone #

How Long? Department Posilion Supervisor Salary (Gross)

Spouse's Previous Employer Previous Employefs Address Prev. Emp. Phone Number

Name & Aclclress Of Closesil Relative Not Living With You Phone Number Relationship

Benlr for Checking Account Brandr Checking Account Number

Bank for Sevings Account Branctr Savings Account Number

NAi'E OF AII OCCUPAI{TS OTHER THATTI APPLICANT I SPOUSE:

Name Relationship Age Name Relationship Age

Name Relationship Age Name Relationship Age

NUMBER AND KIND OF PETS:

Number of Dogs Slze Number of Cals Size other (No. & Kind)

Wer€ you or your spouse €vcr benkrud? Hsv€ you ever been evld€d or bo€n a pslty to a dispute for renl and
for possession of sny r€ntel unit withln the lad five (5) yeas? lf yes, descdbe in &tall:

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LIST ALL LOANS AND MONTHLY PAYMENTS: IF NONE STATE NONE:

$
$
$
$
$
$
$
$
$

REFERRED BY: Newspaper Sign -r-- Agent (Name) Other

The preparation and execution -of this Application does not create a tenancy between Applicant and Orner, or any interest
by Applicant in the Unit described.

Property owneni and local ordinances may limit the number of persons who may occupy a house or apartment.

Any false information given in thls Applicatlon will automatlcally result in refusal of applicant to rent. The above information
is true and coned to the best of my knowledge. You are hereby authorized to verify by means of a Credit Report, Legal
Background Search and by contacl wtth the references and employers.

Date Signature of Applicant

Date Signature of Spouso

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