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Rental Application

* Indicates required fields.

Rental #:

Please Tell Us about Yourself

Last Name: First Name:
Middle: Maiden:
Date of Birth: Marital Status:

Minor Occupants
Name: Age: Relationship:
Name: Age: Relationship:
Name: Age: Relationship:

Pets
Type: Breed: Age: Weight: Tank/Cage:
Type: Breed: Age: Weight: Tank/Cage:
*Please indicate ANY and ALL types of pets (fish, birds, reptiles, etc.) including size of tanks/cages

Contact Information
Home Phone No.: Cell Phone:
Work Phone: *Email:
Present Address:
City: State: Zip:
Own / Rent: Own Rent Since:

Landlord / Mtg. Co.
Name: Phone No.:
Address:
City: State: Zip:

Previous Address:
City: State: Zip:
Own / Rent: Own Rent Since:

Please Tell Us about Your Job

Present Employer: Address:
City: State: Phone:
Position: Start Date:
Monthly Income: End Date:
Description:

Previous Employer: Address:
City: State: Phone:
Position: Start Date:
Monthly Income: End Date:
Description:

Please Give Us the Following Information

Emergency Contact: Address:
City: State: Phone:

Automobiles
Year: Make: Model: Color: Tag #:
Year: Make: Model: Color: Tag #:

Bank Reference: Location:

Have you ever had an eviction filed against you? No Yes
Have you or any occupants ever been arrested for, convicted of, put on probation for, or had adjudication withheld or deferred for a felony offense? No Yes
Have you filed for bankruptcy in the past seven years? No Yes (Discharged? Yes No)
If you answered yes to any of the above questions, please explain:

*This application MUST be returned with the following:
• A copy of your driver's license, or state identification card (if no driver's license)
• Your social security number or a copy of your social security card
• A copy of income verification (paystub, direct deposit form, most recent tax forms, new hire letter of intent)
• A copy of the County license and shot records (for any pets)
• A cashier's check, money order, company, or personal check for $35.00 for EACH application (non-refundable)
*A separate application is to be completed for EACH person 18 years of age or older

APPLICANT understands and agrees that multiple applications may be taken by Landlord or Management for the same property and Landlord or Management may approve who they wish even if multiple applicants qualify. APPLICANT represents that all of the statements and representations are true and complete, and hereby, authorizes verification of the above information, references and credit records. APPLICANT understands that an investigative consumer report including information about character, credit history, general reputation, personal characteristics, mode of living, and all public record information including criminal records may be made. APPLICANT agrees that false, misleading or misrepresented information may result in the application being rejected, will void a lease/rental agreement if any and/or be grounds for immediate eviction with loss of all deposits and any other penalties as provided by the lease terms if any. APPLICANT authorizes verification of all information by the Landlord and or Management Company. NON REFUNDABLE APPLICATION FEE--APPLICANT(s) shall pay to Landlord and/or Management company herewith the sum of $35.00 as a NON REFUNDABLE APPLICATION FEE for costs, expenses and fees in processing the application. GOOD FAITH DEPOSIT: APPLICANT shall deposit a GOOD FAITH DEPOSIT of $______________(equal to one-and-one-half-month's rent if left blank) while the application is being processed.

APPLICANT understands that other applications may be processed and another approved APPLICANT may be chosen. If APPLICANT is approved by Landlord and/or Management and the lease is entered into the GOOD FAITH DEPOSIT shall be applied toward the security/damage deposit. If APPLICANT is approved and chosen, but fails to sign the lease within 3 days of verbal and/or written approval and/or take possession after lease signing, the FULL GOOD FAITH DEPOSIT shall be forfeited to the Landlord or Management in addition to any penalties as provided in the lease if the lease has been signed by the APPLICANT. The GOOD FAITH DEPOSIT shall be refunded only if APPLICANT is not approved and chosen. Keys will be furnished only after lease and other rental documents have been properly executed by all parties and only after applicable rent, fees, deposits and security deposits have been paid. This application is preliminary only, in no way implies that a particular rental unit shall be available and in no way obligates Landlord or Management to execute a lease or deliver possession of the proposed premises to the APPLICANT. Landlord or Management may withdraw approval even after approval at any time before a lease agreement is fully executed for any reason.

By electronically signing below, you are stating that you have read and agree to the provisions as stated.

*Applicant Signature: *Date:

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