ANDREWS & ANDREWS PROPERTIES

5564 HEATHERDOWNS BLVD.

LEASING OFFICE

TOLEDO, OHIO 43614

RENTAL APPLICATION

(419) 349-7291 (Kevin)

(419) 349-2487 (Danielle)

(419) 720-2940 (Fax)

Complete the application truthfully; all blanks must be filled in.

The undersigned hereby makes application to rent unit number

______located at ______beginning on ______

at a monthly rent of $______.

Please tell us about yourself:

Full name ______Middle ______Phone ( ) ______

Previous Last Name______

Date of birth______Social Security No. ______

Name of Co-Applicant ______

Number of Dependents (excluding Co-Applicant) ______

Names & Ages & Relationship______

Pets, no dogs allowed (number & kind) ______

Marital Status______

In an emergency, whom could we notify? ______

Relationship______

Phone No.______

Please give your residence history for the past 3 years:

(Beginning with the most current)

Current Address______

Month/Year moved in______Reason for leaving______

Current Landlord’s Name & Telephone Number______

Previous address (If within 3 years) ______

Month/Year moved in______Moved out______

Reason for moving______

Landlord’s Name & Telephone Number______

Previous address______

Month/Year moved in______Moved out______

Reason for moving______

Please give your employment information:

Your status: ( ) Employed Full-time ( ) Employed Part-time

( ) Student ( ) Retired ( ) Unemployed

Employer______

Dates Employed______Employed as______

Supervisor ______

Address______

Salary $______per ______

Previous Employer ______

If there are any other sources of income that you would like us to

consider please list ______

Please list your bank and credit references:

Your Bank(s) City/State 1.______

2.______

Credit ReferencesCity/State

1.______

2.______

Vehicles:

Make______Model______Color______Year______

License Plate # ______State______

Make______Model______Color______Year______

License Plate # ______State______

Have you ever:Filed for bankruptcy? () Yes() No

Been evicted from tenancy? ( ) Yes ( ) No

Willfully or intentionally refused to pay rentwhen due?

( ) Yes ( ) No

Are you a registered sex offender? ( ) Yes ( ) No

Have you ever been convicted of a felony? ( ) Yes ( ) No

Where did you hear about us: ______?

Would you be interested in having our Buckeye Broadband Representative contacting you to help transfer any existing accounts or to get deals on a new account? ( ) Yes ( ) No

Email address:______

Endorsement:

Applicant herby verifies that the above information is correct and

Authorizes verification of all information.

Date______

Signature______