Credit Application
Credit Application
(Each Adult Applicant to separately complete this form)
Date: [date]
Applicant Name: [ap_firstName] [ap_lastName]
Co-Applicant Name: [coAp_firstName] [coAp_lastName]
Residence Desired:
# Bedrooms [bedroomNum] # Bathrooms [bathroomNum]
Location: [location]
Timing of Move in [moveInTime]
History of Residency:
(List below the information for the two prior residences where lived prior to the current address shown on your Tenant Information Sheet)
PREVIOUS ADDRESS [prev_address1], [prev_city1], [prev_state1] [prev_zip1]
RENT OR OWN [rentOwn1]; PERIOD AT LOCATION [yearsAtAddress1]
LANDLORD NAME [landlordName1]
LANDLORD PHONE [landlordPhone1]
WOULD THE LANDLORD GIVE YOU A POSITIVE CREDIT REFERENCE? IF NOT, EXPLAIN: [explainNegRef1];
PREVIOUS ADDRESS [prev_address2], [prev_city2], [prev_state2] [prev_zip2]
RENT OR OWN [rentOwn2]; PERIOD AT LOCATION [yearsAtAddress2]
LANDLORD NAME [landlordName2]
LANDLORD PHONE [landlordPhone2]
WOULD THE LANDLORD GIVE YOU A POSITIVE CREDIT REFERENCE? IF NOT, EXPLAIN: [explainNegRef2];
HAS ANYONE EVER FILED AN EVICTION PROCEDING OR SUIT FOR PROPERTY DAMAGES AND/OR COLLECTION SUIT AGAINST YOU? IF SO, EXPLAIN HERE: [explainEviction]
Applicant References:
1. 1st Reference Name [refName1]; Telephone # [refPhone1],
Relationship to Applicant [refRelation1];
2. 2nd Reference Name [refName2]; Telephone # [refPhone2],
Relationship to Applicant [refRelation2];
3. 3rd Reference Name [refName3]; Telephone # [refPhone3],
Relationship to Applicant [refRelation3];
Other References: [refOther]
History of Civil Judgments (if any)
(List below, from most recent to oldest, the parties, amount, date, and a brief summary of all civil judgments levied against you. INCLUDE ITEMS FROM CREDIT REPORT)
[civilJudgments]
History of Criminal Infractions
(List below, from most recent to oldest, all convictions for criminal matters, include a brief description and the date of each incident)
[criminalInfractions]
Tenant Employment Information
Employer Name [employerName1]
Employer Address [emp_address1], [emp_city1], [emp_state1] [emp_zip1]
Avg Monthly Income [avgIncome1]
Dates of Employment [datesEmployed1]
Self Employed [selfEmployed1]
Telephone # [emp_phone1]
Yrs Employed in this line of work/profession [yearsProfession1]
Position/Title/Description of Responsibilities [employmentDescription1]
*If Employed in above position for less than two years or if currently in more than one position, complete the following for the immediate prior employer:
Employer Name [employerName2]
Employer Address [emp_address2], [emp_city2], [emp_state2] [emp_zip2]
Avg Monthly Income [avgIncome2]
Dates of Employment [datesEmployed2]
Self Employed [selfEmployed2]
Telephone # [emp_phone2]
Yrs Employed in this line of work/profession [yearsProfession2]
Position/Title/Description of Responsibilities [employmentDescription2]
*If Employed in above position for less than two years or if currently in more than one position, complete the following for the immediate prior employer:
Employer Name [employerName3]
Employer Address [emp_address3], [emp_city3], [emp_state3] [emp_zip3]
Avg Monthly Income [avgIncome3]
Dates of Employment [datesEmployed3]
Self Employed [selfEmployed3]
Telephone # [emp_phone3]
Yrs Employed in this line of work/profession [yearsProfession3]
Position/Title/Description of Responsibilities [employmentDescription3]
Monthly Income Information (Note all sources of consistent income)
Gross Monthly Income / Current / TOTALBase Empl. Income / $[cur_baseEmpInc] / $[tot_baseEmpInc]
Overtime / $[cur_overtime] / $[tot_overtime]
Bonuses / $[cur_bonuses] / $[tot_bonuses]
Commissions / $[cur_commissions] / $[tot_commissions]
Business Income (Provide detailed stmts) / $[cur_busIncome] / $[tot_busIncome]
Income from Real Property / $[cur_realPropInc] / $[tot_realPropInc]
Non Rental Income / $[cur_nonRentalInc] / $[tot_nonRentalInc]
Dividends/Interests / $[cur_dividInt] / $[tot_dividInt]
Alimony or Child Support / $[cur_alimonyChildSup] / $[tot_alimonyChildSup]
Social Security Benefits / $[cur_ssBenefits] / $[tot_ssBenefits]
Government Assistance / $[cur_govAssist] / $[tot_govAssist]
Pension or Retirement Income / $[cur_pensionRetireInc] / $[tot_pensionRetireInc]
Other Income: / $[cur_otherInc1] / $[tot_otherInc1[
Other Income: / $[cur_otherInc2] / $[tot_otherInc2]
Other Income: / $[cur_otherInc3] / $[tot_otherInc3]
Other Income: / $[cur_otherInc4] / $[tot_otherInc4]
TOTAL / $[cur_total] / $[tot_total]
*Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the Tenant does not choose to have it considered.
**If the above income does not match income reflected on the most recent pay stubs, please explain why here: [incomeDiscrepancy]
Monthly Combined Expense Information (Note all sources of consistent expenses)
Combined Monthly Expenses / Present / ProposedRent / $[pres_rent] / $[prop_rent]
First Mortgage (P&I) / $[pres_mortgage1] / $[prop_mortgage1]
Second Mortgage (P&I) / $[pres_mortgage2] / $[prop_mortgage2]
Insurance (Home/Renters) / $[pres_homeIns] / $[prop_homeIns]
Real Estate Taxes / $[pres_realEstateTax] / $[prop_realEstateTax]
Home Maintenance (Repairs and Upkeep) / $[pres_homeMaintain] / $[prop_homeMaintain]
Utilities – Gas/Electric / $[pres_utlGasElec] / $[prop_utlGasElec]
Utilities – Telephone/Cell / $[pres_utlPhone] / $[prop_utlPhone]
Utilities – Water/Sewage / $[pres_utlWaterSewage] / $[prop_utlWaterSewage]
Utilities – Cable / TV / $[pres_utlTV] / $[prop_utlTV]
Utilities – Trash Service / $[pres_utlTrash] / $[prop_utlTrash]
Utilities – Internet Service / $[pres_utlInternet] / $[prop_utlInternet]
Auto Loan Payment (1) / $[pres_autoLoan1] / $[prop_autoLoan1]
Auto Loan Payment (2) / $[pres_autoLoan2] / $[prop_autoLoan2]
Auto Loan Payment (3) / $[pres_autoLoan3] / $[prop_autoLoan3]
Auto Insurance / $[pres_autoIns] / $[prop_autoIns]
Life / Health Insurance / $[pres_lifeHealthIns] / $[prop_lifeHealthIns]
Medical & Dental Expenses / $[pres_medicalDentalExp] / $[prop_medicalDentalExp]
Prescriptions / $[pres_prescriptions] / $[prop_prescriptions]
Credit Card Payments (1) / $[pres_ccPay1] / $[prop_ccPay1]
Credit Card Payments (2) / $[pres_ccPay2] / $[prop_ccPay2]
Credit Card Payments (3) / $[pres_ccPay3] / $[prop_ccPay3]
Credit Card Payments (4) / $[pres_ccPay4] / $[prop_ccPay4]
Student Loan Payments (1) / $[pres_studentLoan1] / $[prop_studentLoan1]
Student Loan Payments (2) / $[pres_studentLoan2] / $[prop_studentLoan2]
Student Loan Payments (3) / $[pres_studentLoan3] / $[prop_studentLoan3]
Student Loan Payments (4) / $[pres_studentLoan4] / $[prop_studentLoan4]
Child Support / $[pres_childSupport] / $[prop_childSupport]
Alimony / $[pres_alimony] / $[prop_alimony]
Charitable Contributions / $[pres_charity] / $[prop_charity]
Subscriptions / Papers / $[pres_subscriptions] / $[prop_subscriptions]
Food / Groceries / $[pres_groceries] / $[prop_groceries]
Gas/Fuel / $[pres_gasFuel] / $[prop_gasFuel]
Clothing / $[pres_clothing] / $[prop_clothing]
Other:
[otherName1] / $[pres_other1] / $[prop_other1]
[otherName2] / $[pres_other2] / $[prop_other2]
[otherName3] / $[pres_other3] / $[prop_other3]
[otherName4] / $[pres_other4] / $[prop_other4]
[otherName5] / $[pres_other5] / $[prop_other5]
[otherName6] / $[pres_other6] / $[prop_other6]
[otherName7] / $[pres_other7] / $[prop_other7]
TOTALS / $[pres_total] / $[prop_total
Assets & Liabilities
This statement and any applicable schedules may be completed jointly by both married and unmarried Co-Tenants if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Tenant section was completed about a spouse, this Statement and supporting schedules must be completed about that spouse also.
Completed: Jointly / Not Jointly [spouse]
Liabilities and Pledged Assets. List the creditor’s name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet if necessary. Indicate (*) by those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.
ASSETS
Description [assetDesc] Cash or Market Value [cashMktValu]
Cash Deposit toward purchase held by: [cashDepTowardPurchase]
List Checking and Savings Account Information Below:
Name & Address of Bank, S&I, or Credit Union / Current Balance[finInst_name1]
[finInst_address1]
[finInst_city1], [finInst_state1] [finInst_zip1] / $[finInst_balance1]
[finInst_name2]
[finInst_address2]
[finInst_city2], [finInst_state2] [finInst_zip2] / $[finInst_balance2]
[finInst_name3]
[finInst_address3]
[finInst_city3], [finInst_state3] [finInst_zip3] / $[finInst_balance3]
[finInst_name4]
[finInst_address4]
[finInst_city4], [finInst_state4] [finInst_zip4] / $[finInst_balance4]
Stocks & Bonds (Company name/number & description)
[stocksBonds]
$[stockValue]
Life Insurance not cash value Face Amount / $[lifeInsFaceVal]Subtotal Liquid Assets / $[subTotLiquidAssets]
Real Estate Owned
(Enter market value from schedule of real estate owner) / $[ownedRealEstate]
Vested Interest in Retirement Fund / $[intRetirementFund]
Net Worth of business(es) owned
(Attach Financial Statements) / $[netWorthBusiness]
Automobiles owned
Make / Year / Value[autoMake1] / [autoYear1] / $[autoValuel]
[autoMake2] / [autoYear2] / $[autoValue2]
[autoMake3] / [autoYear3] / $[autoValue3]
[autoMake4] / [autoYear4] / $[autoValue4]
Other Assets (Itemize)
[otherAssetsDesc1] / $[otherAssetsValue1][otherAssetsDesc2] / $[otherAssetsValue2]
[otherAssetsDesc3] / $[otherAssetsValue3]
[otherAssetsDesc4] / $[otherAssetsValue4]
TOTAL ASSETS $[totalAssets]
LIABILITIES (debts) (INCLUDE ALL ITEMS FROM CREDIT REPORT-IF NECESSARY, ATTACH ADDITIONAL SHEETS)
Name and Address of Company
[debt_name1]
[debt_address1]
[debt_city1], [debt_state1] [debt_zip1]
Monthly Payment [debt_payment1] Months Left to Pay [debt_monthsLeft1]
Unpaid Balance [debt_balance1] Account Number [debt_accNumber1]
Name and Address of Company
[debt_name2]
[debt_address2]
[debt_city2], [debt_state2] [debt_zip2]
Monthly Payment [debt_payment2] Months Left to Pay [debt_monthsLeft2]
Unpaid Balance [debt_balance2] Account Number [debt_accNumber2]
Name and Address of Company
[debt_name3]
[debt_address3]
[debt_city3], [debt_state3] [debt_zip3]
Monthly Payment [debt_payment3] Months Left to Pay [debt_monthsLeft3]
Unpaid Balance [debt_balance3] Account Number [debt_accNumber3]
Name and Address of Company
[debt_name4]
[debt_address4]
[debt_city4], [debt_state4] [debt_zip4]
Monthly Payment [debt_payment4] Months Left to Pay [debt_monthsLeft4]
Unpaid Balance [debt_balance4] Account Number [debt_accNumber4]
Name and Address of Company
[debt_name5]
[debt_address5]
[debt_city5], [debt_state5] [debt_zip5]
Monthly Payment [debt_payment5] Months Left to Pay [debt_monthsLeft5]
Unpaid Balance [debt_balance5] Account Number [debt_accNumber5]
Name and Address of Company
[debt_name6]
[debt_address6]
[debt_city6], [debt_state6] [debt_zip6]
Monthly Payment [debt_payment6] Months Left to Pay [debt_monthsLeft6]
Unpaid Balance [debt_balance6] Account Number [debt_accNumber6]
Alimony/Child Support/Separate Maintenance Payments owed to: [debt_alimonyChildTo] in the amount of $[debt_alimonyChildAmount] per month.
Job Related Expense (Child Care, Union Dues, Etc) [debt_jobExpenseDesc] in the amount of $[debt_jobExpenseAmount] per month.
TOTAL LIABILITIES $[totalDebts]
(*Please review your credit report to confirm that all debts listed on said report are detailed above if still in existence)
Net Worth (Total assets Minus Total Liabilities) $[netWorth]
Schedule of Real Estate Property Owned (If additional properties are owned use continuation sheet)
Property Address (1) [property_address1]
[property_city1], [property_state1] [property_zip1]
Type of Property [property_type1]
Present Market Value $[property_marketValue1]
Amount of Mortgage and Liens $[property_mortgageLiens1]
Gross Rental Income $[property_grossRentalInc1]
Mortgage Payments $[property_mortgagePayments1]
Insurance Maintenance $[property_insMaintenance1]
Net Rental Income $[property_netRentalInc1]
Property Address (2) [property_address2]
[property_city2], [property_state2] [property_zip2]
Type of Property [property_type2]
Present Market Value $[property_marketValue2]
Amount of Mortgage and Liens $[property_mortgageLiens2]
Gross Rental Income $[property_grossRentalInc2]
Mortgage Payments $[property_mortgagePayments2]
Insurance Maintenance $[property_insMaintenance2]
Net Rental Income $[property_netRentalInc2]
List any additional names under which credit has previously been received and indicate appropriate creditors names and account number(s).
Alternate Name / Creditors Name / Account Number[altName1] / [creditorsName1] / [accountNumber1]
[altName2] / [creditorsName2] / [accountNumber2]
Details of Transaction
a. Purchase prices / $[transDet_purchasePrice]b. Alterations, Improvements, Repairs / $[transDet_alterations]
c. Land (if acquired separately) / $[transDet_land]
d. Refinance (Include debts to be paid off) / $[transDet_refinance]
e. Estimated Closing Costs / $[transDet_closingCosts]
f. PMI, MIP, Funding Fee / $[transDet_fundingFee]
g. Estimated prepaid Items / $[transDet_prepaidItems]
h. Discount (If tenant will pay) / $[transDet_discount]
i. Subordinate Financing / $[transDet_subordFinancing]
j. Tenant’s closing costs paid by seller / $[transDet_tenantClosingCost]
k. Other Credits (Explain) / $[transDet_otherCredits]
l. Loan Amount / $[transDet_loanAmount]
m. PMI, MIP, Funding Fee Financed / $[transDet_fundingFeeFinanced]
n. Loan Amount (Add m & n) / $[transDet_loanAmountMN]
o. Cash / Tenant / $[transDet_cashTenant]
DECLARATIONS
If you answer “yes” to any questions a through I, please use continuation sheet for explanation.
a. Are there any outstanding judgments against you? / [declaTenant_A] / [declaCoTenant_A]b. Have you been declared bankrupt in the past seven years? / [declaTenant_B] / [declaCoTenant_B]
c. Have you had property foreclosed upon or given title or deed in lieu thereof in the last seven years? / [declaTenant_C] / [declaCoTenant_C]
d. Are you a party to a lawsuit? / [declaTenant_D] / [declaCoTenant_D]
e. Have you directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure or judgment?
(This would include such loans as home mortgage loans, SBA loans,
Home improvement loans, educational loans, manufactured home loans,
Any mortgage, financial obligation, bond, or loan guarantee?
If “Yes” provide details, including date, name and number of Lender,
FHA, or VA case number, if any, and reason for the action) / [declaTenant_E] / [declaCoTenant_E]
f. Are you presently delinquent or in default on any federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?
If “Yes” give details as described in the preceding question / [declaTenant_F] / [declaCoTenant_F]
g. Are you obligated to pay alimony, child support, or separate maintenance? / [declaTenant_G] / [declaCoTenant_G]
h. Is any part of the down payment borrowed? / [declaTenant_H] / [declaCoTenant_H]
i. Are you a co-maker or endorser on a note? / [declaTenant_I] / [declaCoTenant_I]
j. Are you a U.S. Citizen? / [declaTenant_J] / [declaCoTenant_J]
k. Are you a permanent resident alien? / [declaTenant_K] / [declaCoTenant_K]
l. Do you intend to occupy the property as your primary residence? / [declaTenant_L] / [declaCoTenant_L]
m. Have you ever been evicted or terminated a Lease Agreement prior to the scheduled Lease term? / [declaTenant_M] / [declaCoTenant_M]
n. Have you had an ownership interest in a property in the last three years? / [declaTenant_N] / [declaCoTenant_N]
1. What type of property did you own-principal (PR) Second home (SH), or investment property? / [declaTenant_N1] / [declaCoTenant_N1]
2. How did you title to the home-solely by Yourself (S), jointly w/your (SP), or jointly w/another person (O) / [declaTenant_N2] / [declaCoTenant_N2]
If any answers for A - I are "yes," please explain.
[decla_explain]
ACKNOWEDGE AND AGREEMENT
The undersigned specifically acknowledge(s) and agree(s) that: 1) all statements made in this application are made for the purpose of entering a Lease and/or Sale Agreement with Randy Hall and/or one of his legal entities (hereafter “Randy Hall”); 2) verification or reinvestigation of an information contained in the application or other submitted information may be made at any time by Randy Hall either directly or through a credit reporting agency, from any source named in this application, 3) the original copy of this application may be retained by Randy Hall, even if the lease and/or sale agreement is not approved: 4) Randy Hall will rely on the information contained in the application and I/we have a continuing obligation to amend and/or supplement the information provided in this application immediately upon the change of any of the material facts which I/we have represented herein: 5) if applicant is untruthful or falsely reports any information on documents submitted to Randy Hall, then at Randy Hall’s option, all payments made shall be forfeited as liquidated damages and the parties will have no further recourse to each other; 6) in the event my/our payments per any agreement become delinquent, Randy Hall may, in addition to all their other rights and remedies, report my/our name(s) and account information to a credit reporting agency(s); 7) Randy Hall makes no representations or warranties, express or implied, to the Tenant(s) regarding the property, condition of the property, or the value of the property.