Rental Application - 447 N Pine Street

Each adult (18 or older) must fill out a separate application.

Applicant Information

Name*

First Middle Last

Any Other Names You've Used In The Past

Date of Birth*

Social Security Number*

Email*

Home Phone*

Work Phone*

Mobile Phone*

Driver's License Number*

All other occupants (under 18):

Date of Birth

Relationship to Applicant

All other occupants (under 18):

Date of Birth

Relationship to Applicant

All other occupants (under 18):

Date of Birth

Relationship to Applicant

Emergency Contacts w/ Phone Numbers (Doctors, Lawyers, Nearest Relative)*

Rental/Residence History

Current Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Monthly Rent*

Date of Residency (From/To)*

Reason for Moving*

Is/Was rent paid in full?*

Did you give notice?*

Were you asked to move?*

Owner/Manager's Name*

First Last

Phone*

Last Rent Amount Paid*

Previous Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Monthly Rent*

Date of Residency (From/To)*

Reason for Moving*

Is/Was rent paid in full?*

Did you give notice?*

Were you asked to move?*

Owner/Manager's Name*

First Last

Phone*

Last Rent Amount Paid*

Employment History

Current Employer*

Occupation*

Dates of Employment*

Name of Supervisor*

Employer's Phone*

Monthly Pay (Gross)*

Previous Employer*

Occupation*

Dates of Employment*

Name of Supervisor*

Employer's Phone*

Monthly Pay (Net)*

Vehicles (Include vehicles belonging to other proposed occupants also)

Make/Model

Color/Year

License Plate

Make/Model

Color/Year

License Plate

References

Name*

First Last

Phone*

Relationship*

Name*

First Last

Phone*

Relationship*

By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you. Furthermore, if you abandon the apartment for any reason then you grant us permission to allow your relative listed above to remove all contents of the dwelling on your behalf.

General Information

Have you ever been late or delinquent on rent?*

Yes
No

Have you ever been evicted?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

Do you smoke?*

Yes
No

Do you have any pets?*

Yes
No

If yes, list type, breed, weight, and age.

Have you ever filed for bankruptcy?*

Yes
No

If yes, please explain why.

When would you be able to move in?*

How long do you think you would be renting from us?*

List any verifiable sources and amounts of income you wish to have considered (optional)

If you were to run into financial difficulty in the future and couldn’t come up with the money to pay the rent, do you know someone that would loan you the money? If so, provide the person’s name, address, & phone # so that we can use them as a reference for you.*

Why are you moving from your current address?*

Is there anything negative in your credit or background check you want to comment on?*

Have you had any reoccurring problems with your current apartment or landlord? If yes, please explain:*

How did you hear about this listing?*

Agreement & Authorization

I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for a townhouse and does not constitute a rental or lease agreement in whole or part. I further understand that there is a non-refundable fee to cover the cost of processing my application and I am not entitled to a refund even if I don’t get the townhouse. Any questions regarding rejected applications must be submitted in writing and accompanied by a self-addressed stamped envelope.

Signature*

Date:*