RESIDENTIAL RENTAL APPLICATION

This form should include your information below and ensure that the
property in question is still available as reported. When you receive
this form, you will be asked to pay a required amount for Housing
Approval Setup (AAS) and Property Collection and Inspection (PIP). ,
Along with up to 40-50% of the rental price activated from your
move-in date and payment of your rental price upon your arrival.
Please note that this is private, confidential and 100% guaranteed
FIRSTNAME:______________________________________________
MIDDLE NAME: ___________________________________________
LAST NAME: _______________________________________
DATE OF BIRT:______________________________________
EMAIL:___________________________________________
(CELL PHONE): __________ (HOME PHONE): __________
CHILDREN (YES/NO), HOW MANY: ______________________
HAS EVER BEEN CONVICTED OF A CRIME (YES/NO) IF YES,
DESCRIBE: _________________________________________

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HAS EVER BEEN CONVICTED OF BANKRUPTCY (YES/NO) IF
YES, DESCRIBE:______________________________________
CURRENT ADDRESS:__________________________________
CITY (*) STATE (*) ZIP CODE: __________________________
WHEN DO YOU PLAN TO MOVE IN: ____________________
HOW LONG DO YOU PLAN TO STAY: ____________________
HOW MANY MONTHLY RENT ARE YOU WILLING TO PAY IN
ADVANCE: _______________________________________
DO YOU HAVE PETS, TYPE OF SPECIES:_________________
HABITS: _________________________________________
DO YOU SMOKE: __________________________________
DRINK: ___________________________________________
I____________________________, hereby confirm that I am
at least 18 years old, I duly declare and warrant that all
information provided in this application is true and correct.
I hereby authorize verification of all references and facts,
including but not limited to current and previous landlords,
employers and personal references.
Furthermore, I hereby authorize the owner/agent to receive
all information Wrongful imprisonment, credit reports, tele checks
and/or criminal background reports. The applicant undertakes to
provide further evidence of achievements and/or personal
references upon request. I am aware that the information provided
in the application may be incomplete or incorrect, which may result

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in a delay in processing, which may result in the rental agreement
being rejected. I hereby waive any claims and release from liability
any person providing or receiving this confirmation or additional
information.
An applicant for employment, housing, or a professional or
occupational license who has a sealed record with the Parole
Commissioner may respond "No Record" to an inquiry contained
herein regarding prior arrests or appearances in criminal court. In
addition, any applicant for employment, housing, or a professional or
occupational license may respond "no record" to inquiries about
prior arrests, court appearances, and convictions in all cases of
criminality or being a child in need of services did not result in that
the complaint was forwarded to the higher court for criminal
prosecution.

Signature of the applicant.________ Date:_____________

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