Rental Application

Property applying for:

OUR FAX# 866-436-4661

Reason you are moving:

Applicant Information

Name:

SSN:

Birthdate:

Phone:

Current Address:

City:

State:

ZIP:

Do you own or rent?

Monthly payment or rent:

How long?

Landlord name and phone:

Cash or ck?

Previous Address:

City:

State:

ZIP:

Did you own or rent?

Monthly payment or rent:

How long?

Landlord name and phone:

Cash/ck?

Employment Information

Current Employer:

Employer Address:

How long?

Phone:

City:

State:

Position:

Are you paid hourly or salary?

Annual income:

Other income?

Co-Applicant Information

Name:

SSN:

Birthdate:

Phone:

Current Address:

City:

State:

ZIP:

Do you own or rent?

Monthly payment or rent:

How long?

Landlord name and phone:

Cash or ck?

Previous Address:

City:

State:

ZIP:

Did you own or rent?

Monthly payment or rent:

How long?

Landlord name and phone:

Cash/ck?

Co-Applicant Employment Information

Current Employer:

Employer Address:

How long?

Phone:

City:

State:

Position:

Are you paid hourly or salary?

Annual income:

Other income?

Other occupants including age & relationship

Have you filed a petition for bankruptcy? ___________Have you ever refused to pay rent when due? _______

Have you ever been evicted from any tenancy? ______

What kind of animals do you have?

I authorize obtaining a credit report and the verification of information provided on this form.

Signature of Applicant:

Date:

Signature of Co-Applicant:

Date: