APPLICATION TO RENT PROPERTY

OFFICE USE ONLY

The undersigned hereby makes an application to rent the following property:

______

Anticipated move date of: ______

At a monthly rent of $______and security deposit of $______

Please answer the following questions fully:

PERSONAL INFORMATION

Number of occupants covered by this application: ______adults ______children

Applicant:

Name:______Date of birth: ______

Current Address: ______

______

Current phone number: Home:______Work: ______Mobile:______

Social Security Number: ______

Driver’s License Number: ______

Description of your vehicle (make, model, year and lic. plate number): ______

Co-Applicant:

Name: ______Date of birth: ______

Current Address: ______

______

Current phone number: Home:______Work: ______Mobile:______

Social Security Number: ______

Driver’s License Number: ______

Description of vehicle (make, model, year and lic. plate number): ______

EMPLOYMENT

Applicant:

Employment status, including occupation and/ or student status: ______

Name, address & phone number of current employer: ______

Length of time with current employer: ______

Position with current employer: ______

Gross monthly income: $______

Name, address and phone number of prior employer if with current emplyer less than one year: ______

______

Co-Applicant:

Employment status, including occupation and/ or student status: ______

Name, address & phone number of current employer: ______

Length of time with current employer: ______

Position with current employer: ______

Gross monthly income: $______

Name, address and phone number of prior employer if with current employer less than one year: ______

______

RENTAL HISTORY

Applicant:

Name, address & phone number of current landlord: ______

______

Date current lease expires: ______

How long have you lived at your current address?: ______

Your immediately previous address: ______

______

Name, address & phone number of immediately previous landlord: ______

______

Have you ever been evicted or sued by a landlord? ______If yes, explain ______

______

Co-Applicant:

Name, address & phone number of current landlord: ______

______

Date current lease expires: ______

How long have you lived at your current address?: ______

Your immediately previous address: ______

______

Name, address & phone number of immediately previous landlord: ______

______

Have you ever been evicted or sued by a landlord? ______If yes, explain ______

______

OTHER

Applicant:

Name, address and phone number of closest relative not residing with applicant: ______

______

Nature of the relationship to that relative: ______

Name of your current creditors, including charge cards, student loans and commercial loans: ______

______

Have you ever been convicted of a criminal offense? ______if yes, explain____

______

Have you ever filed for bankruptcy?______if yes, when______

Do you have any bank accounts?______if yes, please answer the following questions:

Name of bank: ______Type of account______

Account number: ______

Co-Applicant:

Name, address and phone number of closest relative not residing with applicant: ______

______

Nature of the relationship to that relative: ______

Name of your current creditors, including charge cards, student loans and commercial loans: ______

______

Have you ever been convicted of a criminal offense? ______if yes, explain____

______

Have you ever filed for bankruptcy? ______if yes, when______

Do you have any bank accounts?______if yes, please answer the following questions:

Name of bank: ______Type of account______

Account number: ______

CONDITIONS

Landlord may refuse to rent to Applicant if any of the information provided herein is found to be untrue, and may terminate Applicant’s tenancy if information provided herein is found to be untrue after renting to Applicant.

If Landlord rents premises to Applicant, possession of the unit shall not be provided to Applicant until, in Landlord’s sole discretion, the premises are ready for occupancy.

Except as provided in the lease, the Landlord shall not be liable for damages in the event the premises are not ready for occupancy on the date prescribed in the lease, and Landlord shall not be liable for damages in any event where the premises cannot be occupied on the prescribed date because of causes beyond Landlord’s control.

I authorize the person to whom this application is made and any credit bureau or other investigative agency employed by such person to investigate any references herein listed or statements or other data obtained from me or from any other source pertaining to my credit or financial responsibility. I also authorize the person to whom this application is made (including his or her agents) to obtain a copy of my credit report to assist in evaluation my application and, thereafter, to obtain and use in attempting to collect unpaid rent, late fees, or other charges from me.

I CERTIFY THAT LL OF THE INFORMATION I HAVE PROVIDED IN RESPONSE TO THE QUESTIONS CONTAINED IN THIS APPLICATION IS TRUE. I FURTHER CERTIFY THAT I HAVE READ THE CONDITIONS CONTAINED AT THE BOTTOM OF THIS APPLICATION FORM, THAT I UNDERSTAND THEM, AND THAT I VOLUNTARILY SUBMIT THIS APPLICATION.

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Applicant’s Signature:Date:

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Applicant’s Printed Name:

______

Co-Applicant’s Signature:Date:

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Co-Applicant’s Printed Name: