Office: 2202 W. 47th Ave., Anchorage, AK
(907) 258-5367 Fax (907) 258-5542
/ Rental Application
______
Thank you for your interest in our rental properties. Please complete all requested information on the front and back of this form.
Mailing address: P. O. Box 190530, Anchorage, AK 99519
Jo Ellen Smith (907) 240-5367 Michael R. Smith (907) 227-2277
Address of Property Applied for: Desired Date of Occupancy:
(Application Fee: $30 per adult) Rental Rate: $ Security Deposit: $ Pet Deposit: $
Tenant paid util.: Electric; Gas: Refuse; Water/Sewer. Avg. monthly util. cost: $
PERSONAL INFORMATION___ Copy of Photo ID Attached
APPLICANT’S FULL NAME: Date of Birth: Social Security #:
Applicant’s Cell Ph. #: Home Ph. #: Email Address:
CO-APPLICANT’S FULL NAME: Date of Birth: Social Security #:
Co-Applicant’s Cell Ph. #: Home Ph. #: Email Address:
RELATIONSHIP TO APPLICANT:
Other Residents
/Relationship
/Date of Birth
/ / / / / / / / / /Do You Have Pets? Type: Do you smoke?
APPLICANT(S) HISTORY
PRESENT ADDRESS: City: State: ZIP Code:
Present Landlord: Phone #: Length of time at present address:
Amount of Rent: $ Reason for Moving:
CO-APPLICANT’S CURRENT ADDRESS (if different from above):
PREVIOUS ADDRESS: ZIP Code:
Length of time at previous address:
Previous Landlord: Phone #:
Amount of Rent: $ Reason for Moving:
CO-APPLICANT’S PREVIOUS ADDRESS (if different from above): ZIP Code:
Length of time at previous address:
Previous Landlord: Phone #:
Amount of Rent: $ Reason for Moving:
EMPLOYMENT INFORMATION
EMPLOYED BY: Length of employment:
Employer’s Address: Zip Telephone:
Position Held:
Monthly Salary: Supervisor:
CO-APPLICANT’S OR PREVIOUS EMPLOYER: Length of employment:
Employer’s Address: Zip Telephone:
Position Held:
Monthly Salary: Supervisor:
CREDIT REFERENCES
Applicant’s Bank: Co-Applicant’s Bank:
Applicant’s Personal Reference (not related to applicant):
Address: Phone #:
Co-Applicant’s Personal Reference (not related to applicant):
Address: Phone #:
Complete the following only for those accounts that do not appear on credit reports (e.g., private loans, Rent to Own or Reentrance):
Credit Reference: Account Number:
Address: Phone #:
Applicant: Have you ever been convicted of a felony? Date:
Explain circumstances:
Co-Applicant: Have you ever been convicted of a felony? Date:
Explain circumstances:
OTHER INFORMATION
Number of Automobiles (Including Company Cars): Driver’s License No.:
Make: Year: Color: Tag No.: State:
Make: Year: Color: Tag No.: State:
Make: Year: Color: Tag No.: State:
Household Income: $ Per: Receiving rental assistance?
Other Remarks:
In Case of Personal Emergency, Notify (Next of Kin): Relationship:
Address: Telephone:
City: State: Zip:
Co-Applicant’s next of Kin: Relationship:
Address: Telephone:
City: State: Zip:
I hereby submit application for a property and certify that this information is correct. / HAVE YOU OR CO-APPLICANT EVER: Been sued for non-payment of rent? Yes____ No____Been evicted or asked to move out? Yes____ or No____
Been sued for damage to rental property? Yes____ or No____
I authorize you to contact any reference that I have listed and authorize those references listed to release information to JEMS Real Estate, LLC. / Applicant’s SignatureDate
Signature authorizes JEMS Real Estate LLC to complete a full credit check and back-ground check on the applicant(s). / Co-Applicant’s SignatureDate
FOR OFFICE USE ONLY -- DO NOT WRITE BELOW
Date Application Received Received by
REFERENCE VERIFICATION / REMARKS / RECORD OF ADVANCE DEPOSITS RECEIVEDPresent Landlord / Date / Description / Amount / How pd.
Previous Landlord
Employment
Co-App Employment / This Application: Approved Not Approved
Bank Reference / By:
Credit Reference / Assigned Unit No.:
Personal Reference
Credit Report / Move-In Date