Which Will Be Copied and Attached to This Application

Office: (913) 262-2258 Fax: (913) 262-2179

Personal Information
First Name / Middle / Last / SS#
Date of Birth
/ / / Marital status
Single Married Since______Divorced Since______
Phone
- - / Phone
- - / Email
Drivers License # State
Present Home Address / City/ State/ Zip
Date move in / Present Landlord / Landlord Phone
- -
Reason For Leaving / Amount of Rent / Are you Current on Your Rent?
Yes No
Previous Home Address / City/ State/ Zip
Dates at Address / Pervious Landlord / Landlord Phone
- -
Reason For Leaving / Amount of Rent / Were you Current on Your Rent?
Yes No
Next Pervious Home Address / City/ State/ Zip
Dates at Address / Pervious Landlord / Landlord Phone
- -
Reason For Leaving / Amount of Rent / Were you Current on Your Rent?
Yes No
Rental Occupancy Date
/ / / Rental Due Date / /
Monthly Biweekly ($10 more) Weekly ($30 more)
Do you have Renter’s Insurance?
Yes No / Have you ever broken a Lease?
Yes No / Have you ever refused to pay rent for any reason?
Yes No / If so, Why?
Have you ever been evicted or asked to leave a rental unit?
_____Yes No / Have you ever filed bankruptcy?
Yes No / Have you ever been convicted of a crime?
Yes No / Do you give us permission to do a criminal background check?
Yes No
Do you currently have utilities in your name?
Yes No / Do you have phone service in your name ?
Yes No / Is there anything preventing you from placing utilities or a phone in your name?
Yes No
Do you know of anything or any reason that may interrupt your ability to pay rent?
Yes No / Do you own a lawn mower?
Yes No / Do you agree to maintain gutters at least once per year?
Yes No / Do you own a refrigerator?
Yes No
Proposed Occupant(s) (If any proposed occupant smokes, please check the box by name)
Name: / Relationship: / Occupation: / Date of Birth:
Name: / Relationship: / Occupation: / Date of Birth:
/ / /
Name: / Relationship: / Occupation: / Date of Birth:
/ / /
Name: / Relationship: / Occupation: / Date of Birth:
/ / /
Proposed Pets
Name: / Type/ Breed: / Weight: / Age:
Name: / Type/ Breed: / Weight: / Age:
Name: / Type/ Breed: / Weight: / Age:
ON APPROVAL OF APPLICATION A PHOTO OF EACH PET MUST BE PROVIDED
Vehicle(s) Information
Number of vehicles on the property: / Valid Registration and inspection?
Yes No / Do you have any commercial vehicles, campers, boats, or motorcycles?
Yes No
Vehicle #1 Year: / Make: / Model: / Color: / Plate #: / State:
Financed/ Leased Through? / Phone Number:
( ) -
Account Number: VIN#: / Monthly Payment:
Vehicle #2 Year: / Make: / Model: / Color: / Plate #: / State:
Financed/ Leased Through? / Phone Number:
( ) -
Account Number: VIN#: / Monthly Payment:

Top of Form

Employment
Current Employer / Occupation / Hours/ Week
Salary Weekly Biweekly Monthly Annual Average
Supervisor / Phone
( ) - - / Years Employed
Address / City/ State/ Zip
Current Employer / Occupation / Hours/ Week
Supervisor / Phone
( ) - - / Years Employed
Address / City/ State/ Zip

Bottom of Form

Income
Current income $______
Weekly Biweekly Monthly Yearly / Source: / Proof of Income:
Yes No
Current income $______
Weekly Biweekly Monthly Yearly / Source: / Proof of Income:
Yes No
Current income $______
Weekly Biweekly Monthly Yearly / Source: / Proof of Income:
Yes No
Current income $______
Weekly Biweekly Monthly Yearly / Source: / Proof of Income:
Yes No
Cards and Loans
Creditor / Address
Phone
( ) - - / Account #
Total Amount Owed / Monthly Payment / Are your payments current?
Yes No
Creditor / Address
Phone
( ) - - / Account #
Total Amount Owed / Monthly Payment / Are your payments current?
Yes No
Creditor / Address
Phone
( ) - - / Account #
Total Amount Owed / Monthly Payment / Are your payments current?
Yes No
Other Monthly Expenses
Health Insurance: / Auto Insurance: / Renter’s Insurance:
Hospital Payments: / Child Care: / Tuition:
Cable TV: / Other: / Other:
Total Monthly Expenses:
References
Bank Reference
Name of bank and branch: / Address:
Phone Number:
( ) - / Account number: / Account Number:
Personal/ Professional References
Personal/character reference
Name: / Address: / City/State/ Zip
Relationship: / How Long: / Phone:
( ) -
Professional Reference (e.g. attorney, accountant)
Name: / Address: / City/State/ Zip
Relationship: / How Long: / Phone:
( ) -
Nearest living relative
Name: / Address: / City/State/ Zip
Relationship: / How Long: / Phone:
( ) -
Do you give owner or manager permission to contact the references listed above both now and in the future for rental consideration or for collection purposes should that be deemed necessary? Yes No
Additional Income/ Payment Information
In the event of some emergency that would prevent you from paying rent when due, is there a relative, person, or agency that could assist you with rent payments?
Yes No
Emergency Contact
Name / Address: / Relationship:
Phone
( ) - / Additional Phone
( ) -
Co-signor Information
First Name / Middle / Last
Date of Birth
/ / / Marital status
Single Married Since______Divorced Since______
Phone
- - / Phone
- - / Email
Drivers License # State / SS#
Present Home Address / City/ State/ Zip
How were you referred to us?
Sign Internet Referral ______ Other ______
How do you anticipate staying at this location?
1 yr 3 yr 5 yr
Why would you move, or relocate?

A COMPLETED APPLICATION REQUIRES:

submission of the following:

which will be copied and attached to this application:

DRIVER’S LICENSE
or government-issued picture ID [Note: Rentals will not be shown without picture ID]
Copy of voided PERSONAL CHECK (to verify bank)
Two most current PAY STUBS of each income source listed
If self-employed, most current Schedule C tax return and proof of current income

A fee of $ 45.00 is charged on each rental applicant for the purpose of verifying the information furnished in this application. By signing below, applicant hereby represents that all information on this application is true and complete and hereby authorize Excellent Rentals and its agents annual verification of information, references, and credit history for continual rental consideration or for collection purposes should that become necessary. This fee is refundable only if applicant meets our minimal criteria but is not selected because he or she was not the first qualified applicant.

Additionally, I authorize all corporations, companies and law enforcement agencies, academic institutions, and current and former employers to release information they may have about me and release them from any liability and responsibility from doing so. A photographic or faxed copy of this authorization shall be as valid as the original.

Applicant acknowledges this application will become part of the lease agreement when approved. If any information is found to be incorrect, the application will be rejected and any subsequent rental agreement becomes void.

Thank you for completing the rental application.

Please sign below.

Applicant’s signature:______Date:______

Co-applicant’s signature: ______Date:______

ORIGINAL DOCUMENTS MUST BE DELIVERED TO LEASING AGENT FOR TENANT’S PERMANENT FILE

Every Occupant over the age of 18 MUST fill out a separate application (even if married). Please fill out this form COMPLETELY and sign where indicated.

A fee of $______will be collected as a holding fee for the property.

This will hold the property for up to 30 days ONLY at which time rent will commence and be due and payable. The holding fee is then converted to the deposit fee. The holding fee is non refundable if, after 24 hours from receiving approval status, the renter chooses not to rent the property.

Security Deposit:______

PET Deposit:______

MONTHLY RENT______

Monthly Pet Rent:______

Refrigerator Rent______

Total Required RENT:______

DEPOSIT DUE:______

Paid:YES NO

Applicant Signature:______

Leasing Agent: ______

Mail to: 215 East 20th Street, Kansas City, MO 64108 FAX: 913-262-2179

Every Occupant over the age of 18 MUST fill out a separate application (even if married). Please fill out this form COMPLETELY and sign where indicated.

1. Rental Application NEW 12-2015.docx12/6/14