RENTAL APPLICATION Every applicant over the age of 18 must fill out separate application

PERSONAL INFORMATION

Property/Unit Applying for: *

First Name: *

Middle Initial: *

Last Name: *

Date of Birth: *

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Social Security #: *

Phone Number: *

Work Phone Number:

E-mail *

RENTAL HISTORY

1) Current Address: *

City: *

State: *

ZIP Code: *

Owner/Manager Name: *

Phone Number: *

Date In: *

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Date Out: *

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Reason for Moving: *

2) Previous Address: *

City: *

State: *

ZIP Code: *

Owner/Manager Name: *

Phone Number: *

Date In: *

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Date Out: *

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Reason for Moving: *

All Other Proposed Occupants:

1) First Name:

Middle Initial:

Last Name:

Relation:

2) First Name:

Middle Initial:

Last Name:

Relation:

EMPLOYMENT/INCOME

Present Occupation/Primary Source of Income: *

Employer/Source of Income Name: *

Address: *

Phone: *

Start Date: *

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End Date: *

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Current Gross Income: *

Per: *

Week Month Year

Additional Source of Income:

Secondary Employer/Additional Source of Income Name:

Address:

Phone:

Start Date:

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End Date:

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Additional Gross Income:

Per:

Week Month Year

GENERAL INFORMATION

Proposed Pet/s: *

Vehicle/s: *

Emergency Contact: *

References: *

Has Applicant ever filed for bankruptcy? *

No Yes

If yes, please explain:

Has Applicant ever been convicted of a felony? *

No Yes

If yes, please explain:

Has Applicant ever broken a lease? *

No Yes

If yes, please explain:

Has Applicant ever been brought to court by a landlord? *

No Yes

If yes, please explain:

Has Applicant ever been evicted? *

No Yes

If yes, please explain:

Has Applicant ever moved owing rent or having damaged a property? *

No Yes

If yes, please explain:

Is the total move in amount available now (rent & deposit)? *

Yes No

If no, please explain:

Application Fee $35 per application *

I understand my application cannot be processed until the application fee has been paid.

Documentation: *

I understand my application cannot be processed until the following documentation has been submitted: copy of driver"s license/valid photo ID, proof of all income listed for the last 30 days. Please attach documents below.

Attachment 1:

Attachment 2:

Attachment 3:

Disclosure/Release: *

In connection with my application for tenancy I understand that consumer reports which may contain public record information may be requested from a consumer reporting agency. These reports may include information related to employment, tenancy, credit, criminal records, court records etc. from federal, state and other agencies which maintain such records. I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY THE CONSUMER REPORTING AGENCY TO FURNISH THE ABOVE MENTIONED INFORMATION. I have the right to make a request to the consumer reporting agency, ParaSearch, Inc. upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which the agency has previously furnished within a two year period for employment requests, and one year for other purposes preceding my request. I hereby consent to your obtaining the above information from the agency; and I agree that such information which the agency has or obtains, and my tenancy history with you, may be supplied by you to the agency for release to other companies which subscribe to the agency"s services. I hereby authorize procurement of consumer report(s). I authorize present and past landlords, employers, creditors, references and other sources to be contacted as deemed necessary to process this application. I represent that all information provided is true, accurate, and complete to the best of my knowledge.

Electronic Signature: *