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RENTAL APPLICATION

Neatly complete all information below. All applicants over the age of 18 must complete and sign their own application.

Applicants full name___________________________________Phone #___________________DOB__________

Social Security #____________________Drivers License #____________________State________Exp.________

Current Address________________________________City___________________State________Zip_________

Current Landlords Name__________________________________Landlords Phone #______________________

How long at this address__________Reason for leaving______________________________________________

Previous Address________________________________City___________________State_______Zip_________

Previous Landlords Name__________________________________________Phone #______________________

How long at this address__________Reason for leaving______________________________________________

Auto Yr______Make____________Model_____________________State/License Plate #___________________

Present Employer_____________________________Position__________________Mo. Income______________

Phone #__________________How long at job_________Other income/source____________________________

Employers Address_________________________________________City___________________State________

Number and type of Pets___________________________Have you ever been party to an eviction? [ ] Yes [ ] No

Name of bank_________________________Branch_____________________Type of Account_______________

Personal References

Name______________________________Yrs. Known____Relationship____________Phone #______________

Total number of adults___________Total number of children living with you under the age of 18_____________

Names and relations of all other applicants_________________________________________________________

___________________________________________________________________________________________

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize

investigation of all statements contained in this application for tenant screening as may be necessary in arriving at

a tenant decision, I understand that the landlord may terminate any rental agreement entered into for any

misrepresentations made above.

Signature________________________________________________________________Date________________

Fax 407 905 5430