Instructions: 
A separate application must be filled out by each applicant, even if married. Completely fill out each blank, read and understand the terms of use and click the submit button. If accepted, rent and deposit are due upon signing lease agreement. We award points for honesty and accuracy.
  

Your current monthly rent or house payment $
Date you would like to move
The money you can raise to apply towards moving into this property $
Property interested in obtaining
  
PERSONAL----------------------------------------------------------------------------------------------------------
Applicant Name

Marital Status Single   
                     Married     Date married
                     Divorced   Date divorced
                         Former spouse name
 
Birth Date     SS#     
Drivers Lic. State   #
  
ADDRESSES------------------------------------------------------------------------------------------------------

Present Address (street, city, state, zip)
Lived there since  
Rent/Month $  
Current Home Phone  
Current Landlord's Name  
Current Landlord's Phone  
Is current rent up to date?   Yes  No
Have you given notice?   Yes  No
Have you been asked to leave?   Yes  No
  

Previous Address (street, city, state, zip)
From/To Dates  
Rent/Month $  
Previous Landlord's Name  
Previous Landlord's Phone  
Was rent up to date?   Yes  No
Had you given notice?   Yes  No
Had you been asked to leave?   Yes  No
 
EMPLOYMENT-----------------------------------------------------------------------------------------------

Present Employer    Since
 
Present Employer Address (street, city, state, zip)
What do you do?  
Number of years in this type of work  
Supervisor's Name  
Supervisor's Phone  
Number of hours per week  
    

Previous Employer    
                      From   To
 
Previous Employer Address (street, city, state, zip)
What did you do?  
Number of years in this type of work  
Supervisor's Name  
Supervisor's Phone  
Number of hours per week  

INCOME----------------------------------------------------------------------------------------------------------
Current Income  $ 
Source
 
Current Income  $ 
Source

Current Income  $ 
Source

Current Income  $ 
Source

Bank/Credit Union Name
Account #

Bank/Credit Union Name
Account #


ASSETS----------------------------------------------------------------------------------------------------------
Do you own your car? Yes  No      Current value $
Do you own any other vehicles or boats? Yes  No      Total value $
Life Insurance? Yes  No      Value $
Stocks/Bonds? Yes  No      Value $
 
REFERENCES---------------------------------------------------------------------------------------------

Relative
   Relation
Address (street, city, state, zip)

Phone


Non-Relative
   Relation
Address (street, city, state, zip)

Phone

Non-Relative
   Relation
Address (street, city, state, zip)

Phone

Emergency Contact
  
Address (street, city, state, zip)

Phone

Is anyone willing to help you financially in owning your own home? Yes  No
Name   How much $


 
CREDIT ACCOUNTS------------------------------------------------------------------------------
List all current (open) credit accounts, including credit card(s). If additional space is needed please continue in the comments section.

 Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No
 
Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No
 
Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No
 
Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No
 
Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No
 
Creditor Name
   Account #   Payment $
Address (street, city, state, zip)
  Current? Yes  No


Explain any of the following "Yes" answers in the comments section with names and details.
Has applicant ever been sued for bills?  Yes  No
Has applicant ever filed bankruptcy?  Yes  No
Has applicant ever broken a lease?  Yes  No
Has applicant had a foreclosure?  Yes  No
Has applicant ever been evicted?  Yes  No
Is the total move-in amount available now (rent & deposit)?  Yes  No


Comments or Questions
 
Do you know anyone who could benefit from our services? Yes  No
Name Phone

 
CONSENT TO RELEASE INFORMATION--------------------------------

The information on this application form is strictly confidential and will be kept so by the management. The purpose of the information is to verify your credit qualifications. The applicant agrees to allow a full credit and criminal examination and hereby authorizes management to contact any agencies, offices, groups, organizations, employers, current and past landlords, creditors, neighbors, or references listed to obtain and verify any information or materials which is deemed necessary to complete my application and/or on an annual basis to evaluate for renewal consideration or to assist in contacting me should it become necessary to locate me relevant to matters involved in this tenancy.

I state that all the information is true, accurate, and complete to the best of my knowledge. Manager reserves the right to disqualify tenant if information is not as represented.

I state that the acceptance of these terms and submission of this form is sufficient to authorize the disclosure and/or exchange of information, and that any persons or firm is authorized to release information about me upon presentation of this form.

I accept these terms                        I do not accept these terms

Date    Email Address