RENTAL APPLICATION FORM

TODAY’S DATE: ________________ ADDRESS APPLIED FOR:

_______________________________

APPLICANT’S INFORMATION

LAST NAME: _____________________ FIRST: _________________________ MI: _______

SS#: _______ DATE OF BIRTH: ________________________ PHONE#:______________________

PREVIOUS ADDRESS: __________________________________________________________________________

STREET CITY STATE ZIP

Landlord or Mortgage Co.: _____________ Phone (required): ________________ Rent Amount: ______

Reason for Leaving: ______________________________________________________________________________

Single or Married: ______________________

Proposed Occupants/Ages: 1) _______ 2) _______ 3) _______ 4) _______ 5) _______

Pet: ___________________________________ Vehicle: Type __________________ Smoker: Yes____ No ____

Earliest Possible Date of Deposit Payment: ___________________________________________________________

How much do you have at hand now to secure the property: ____________________________________________

Proposed Move-in Date: ______________________

EMPLOYMENT STATUS

Full Time: _____ Part Time: _____ Unemployed: _____ Student: _____ Retired: _____

Employed by: __________________________________ how long have you work there: ________________

Address: ______________________________________________________ Phone#: _______________________

Personal Reference: _____________________________________________ Phone#: ______________________

Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above items
including, but not limited to, the obtaining of a credit report.

A refundable application fee of $100 should be settled on receiving this form.

Dated: ____________________ Applicant Signature: ____________________________

PLEASE TAKE A PICTURE OF YOUR ID AND ATTACH WHEN SENDING THE RENTAL
APPLICATION FORM FOR PROPER CHECKS THANK YOU FOR WORKING WITH US.
GOD BLESS YOU.