Applicant
Name__________________________________
Phone ________________________
Date of Birth______________________ Age_________ SocSec#_______________________________
Email________________________ (optional) Other Phone ___________________
Current Address ______________________________City______ State____
Month/Year Moved In_____________________ Reasons for Leaving____________________________ Rent $__________
Owner/Agent____________________________ Phone ___________________________
Previous Address_________________________________ Rent $____________
Owner/Agent____________________________ Phone____________________________ Month/Year Moved In_____________________
Employment Your Status: _____Full Time _____Part Time _____Student _____Unemployed ____ Retired
Employer_______________________________
Years employed ______Position______________________
Supervisor______________________________________ Phone _____________________________
Monthly Income______________ Other income_________
Previous Employer_______________________________
Years employed ______Position______________________
Supervisor______________________________________ Phone _____________________________
Monthly Income________________.
Do you smoke tobacco? Yes______ No______ Have you declared bankruptcy in the past seven (7) years? Yes___________ No____________ Have you ever been evicted from a rental residence? Yes___________ No____________ Have you had two or more late rental payments in the past year? Yes___________ No____________ Have you ever willfully or intentionally refused to pay rent when due? Yes___________ No____________
Other Occupants /Family members: Name______________________________ Age_______ Name______________________________ Age_______ Name______________________________ Age_______
Do you have any animals?________ If so, how many, what kind, breed and age _______________________________ ________________________________________________ Is this a service animal? ___________________________
Applicant Signature________________________________________
Co-Applicant
Name__________________________________
Phone ________________________
Date of Birth______________________ Age_________ SocSec#_______________________________
Email________________________ (optional) Other Phone ___________________
Current Address ( if different) ______________________________City_____ State____
Month/Year Moved In_____________________ Reasons for Leaving____________________________ Rent $__________
Owner/Agent____________________________ Phone ___________________________
Previous Address _________________________________ Rent $____________
Owner/Agent____________________________ Phone____________________________ Month/Year Moved In_____________________
Employment Your Status: _____Full Time _____Part Time _____Student _____Unemployed ____ Retired
Employer_______________________________
Years employed ______Position______________________
Supervisor______________________________________ Phone _____________________________
Monthly Income______________ Other income_________
Previous Employer_______________________________
Years employed ______Position______________________
Supervisor______________________________________ Phone _____________________________
Monthly Income________________.
Do you smoke tobacco? Yes______ No______ Have you declared bankruptcy in the past seven (7) years? Yes___________ No____________ Have you ever been evicted from a rental residence? Yes___________ No____________ Have you had two or more late rental payments in the past year? Yes___________ No____________ Have you ever willfully or intentionally refused to pay rent when due? Yes___________ No____________
The above applicant/ co-applicant certifies the above information is true and complete and authorizes the release of information for owner/agent to verify the above information by making contact with employers, rental references, credit checks, criminal background checks and make any other inquiry reasonable necessary to evaluate potential tenancy. Applicant/ Co-applicant authorize the release of related information from those sources. Any false statements on this application may be grounds for denial of tenancy or immediate termination of tenancy.
Co-Applicant Signature________________________________________
