Horizon Home Rentals LLC

RENTAL APPLICATION

Today’s date ______/ Anticipated move-in ______/ 2203 Drake Dr., Xenia
Monthly rent $600 / Security deposit $600 / Pet deposit $250 non-refundable

Applicant

Full name ______/ Address ______
Telephone ______DOB ______SS # ______DL# ______
Current employer ______/ Former employer ______
Address ______/ Address ______
Position ______/ Position ______
Supervisor ______phone ______/ Supervisor ______phone ______
Date started ______Mo. income $______/ Date started ______Mo. income $______
Other income ______Mo. $ ______/ Other income ______Mo. $ ______

Co-applicant

Full name ______/ Address ______
Telephone ______DOB ______SS # ______DL# ______
Current employer ______/ Former employer ______
Address ______/ Address ______
Position ______/ Position ______
Supervisor ______phone ______/ Supervisor ______phone ______
Date started ______Mo. income $______/ Date started ______Mo. income $______
Other income ______Mo. $ ______/ Other income ______Mo. $ ______

Other occupants

Name Relationship DOB

______/ ______/ ______
______/ ______/ ______
______/ ______/ ______
______/ ______/ ______
______/ ______/ ______

Pets

Type ______/ Breed ______/ Weight ______/ Age ___
Type ______/ Breed ______/ Weight ______/ Age ___


References

Present landlord ______/ Rental address ______
Phone ______Mo. rent $______/ Reason for moving ______
Previous landlord ______/ Rental address ______
Phone ______Mo. rent $______/ Reason for moving ______
Personal reference ______/ Relationship ______phone ______
Personal reference ______/ Relationship ______phone ______
Personal reference ______/ Relationship ______phone ______
Current bank ______/ Checking Y / N Savings Y / N
Credit reference ______/ Type of loan ______Mo. payment $_____
Credit reference ______/ Type of loan ______Mo. payment $_____
Credit reference ______/ Type of loan ______Mo. payment $_____

Credit / criminal history

Have any of the occupants declared bankruptcy or other credit reorganization? / Y / N Date ______
Have any of the occupants broken a lease or other rental agreement? / Y / N Date ______
Have any of the occupants been convicted of a felony? / Y / N Date ______

Additional comments to be considered: ______

Attestation

I have provided and examined the above information and it is my belief that the provided information is true, correct and accurate. I authorize the prospective landlord to use this and other collected information to conduct any and all investigations as deemed prudent.

______

Applicant signature Date Co-applicant signature Date

______

Printed name(s)

______

Email address(es)

Horizon Home Rentals LLC use only

______

______

______

Horizon Home Rentals LLC

Beavercreek, OH 45432

(937) 320-1896 office