Applicant Info

First Name:______Last Name:______

Present Address:______

SSN:______-______-______Birth Day:_____/______/______

Phone:(______)______Cell Phone:(______)______

Drivers License______Smoke?:Yes ______No _____

+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +

Co-Applicant Info

First Name:______Last Name:______

Present Address:______

SSN:______-______-______Birth Day:_____/______/______

Phone:(______)______Cell Phone:(______)______

Drivers License______Smoke?:Yes ______No _____

Others who will be living in this House

Name:______Relationship:______Age:______

Current Address

Address:______

City:______State:______Zip:______

Property Manager ______Phone:(_____)______

Start Date:_____/______/______End Date:______/______/______

Leave Reason:______

Past Address

Address:______

City:______State:______Zip:______

Property Manager:______Phone:(_____)______

Start Date:_____/______/______End Date:______/______/______

Leave Reason:______

Employment History

Ocupation ______

Company:______

Name of Manager:______Phone:(_____)______

Address:______

City:______State:______Zip:______

How long have you worked there:______

Monthly Pay:______

+ + + + + + + + + + + + + + + + + + + + + + + + + + +

Co-Applicant Employment History

Ocupation ______

Company:______

Name of Manager:______Phone:(_____)______

Address:______

City:______State:______Zip:______

How long have you worked there:______

Monthly Pay:______

Personal References

Name:______Relationship:______Phone:(___)______

I Case of Emergency Notify ______Relationship______

Automobile Information

Make:______Year_____ Model:______Plate #:______

Have you ever been convicted of a crime? ______

Describe and Date each one ______

Have you ever been a house owner______

Have you ever had a foreclosure______

Have you ever been evicted, declared bankruptcy or had a judgement? ______

Describe and Date each one ______

_____ I agree to the following statement I represent that the information provided in this application is true, complete and accurate to the best of my knowledge.

_____ I agree to the following statementI understand that the information provided might be used by Landlord to determine whether to accept this application. I authorize Landlordto verify all the information given in this application, including

past rental information, personal references and employment information

provided. I authorize the Landlord to obtain a current credit and criminal background check.

_____ I agree to the following statementI understand that this application is not a rental agreement and that this application does not create any obligation on the Landlord

The undersigned represent that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for eviction.

Print Name:______

Signature:______Date:___/___/____

Print Name:______

Signature:______Date:___/___/____