RENTAL APPLICATION FORM

First name

Last name

Home / Cell Phone

Work Phone

Birthday

Month

Day

Year

SSN

Driver's License #

ADDRESSES

Current Address

Date In and Date Out

Landlord's Name

Landlord's Phone Number

Reason For Leaving

Previous Address

Date In and Date Out

Landlord's Name

OTHER OCCUPANTS

OTHER OCCUPANTS; Names and Birthdates 18 Years or Older

OTHER OCCUPANTS; Names and Birthdates 18 Years or Younger

PETS (Y/N)

Yes

Describe Pet

EMPLOYMENT AND INCOME INFORMATION

EMPLOYMENT & INCOME INFO. Occupation (1)

Employer/Company

Supervisor Name

Supervisor Phone

Monthly Salary

Start Date and End Date

EMPLOYMENT & INCOME INFO. Occupation (2)

Employer/Company

Supervisor Name

Supervisor Phone

Monthly Salary

Start Date and End Date

1. Other Montly Income

Describe Source

2. Other Montly Income

Describe Source

EMERGENCY CONTACTS AND REFERENCES

EMERGENCY CONTACT Name / Address / Phone / Relationship

REFERENCE Name / Address / Phone / Relationship

Filed for Bankruptcy?

Yes

Been Convicted of a Crime?

Yes

If Yes, describe

We authorized Landlord and its agent to obtain an investigative consumer report including credit history, court records, and registered sex offender search. I authorize the release of informatin from previous or current landlords, employers, and bank representatives. This investigation is for resident screening purposes only. I hereby hold Landlord and its agents free and harmless of any liability for any damages araising out of any improper use of this information.

Signature (Sign Form and Submit)

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Please also send the following to halonso1@gmailcom:

(1) Copy of your credit report from your credit card (if you have one)
(2) Copy of 2 month Income Verification.

RENTAL APPLICATION FORM

Please also send the following to halonso1@gmailcom: (1) Copy of your credit report from your credit card (if you have one) (2) Copy of 2 month Income Verification.

Please also send the following to halonso1@gmailcom:

(1) Copy of your credit report from your credit card (if you have one)
(2) Copy of 2 month Income Verification.