Copy of Online Rental Application

Please complete this application with all applicable details. If you are accepted as a tenant, this application will become part of the lease. If more than one tenant (other than minor children) will be occupying in a unit, each must complete a separate application. By signing below, you represent that the information provided is true and complete, you authorize lessor to contact third parties to verify the information given, and you specifically authorize lessor to check on your credit through a credit-reporting agency. A non-refundable application fee of $5.00 must be paid to cover the lessor's expenses in verifying the information you provide.

1. Contact Information: Applicant Name; First, Middle, Last:

2. Address of Property you are interested in: Property Address:

2. Contact Information: Home Phone:

3. Contact Information: Cell Phone:

4. Contact Information: Email Address:

5. Sex: Check one: Male
Female

6. Social Security Number: If you have any security concerns, please enter XXX-XX-XXXX and call us with this information after submitting the application:

7. Birth Date: Example: December 15, 2012:

8. Driver's License No.: Issuing State:

9. List ALL people who will reside in the unit in addition to the applicant: Include Complete Name, Gender, Age, and their Relationship to Applicant:

10. What is your TOTAL household income?: What is the source of this income?:

11. Name of Current Employer:

12. How long have you been employed?: Less than 1 year 1 to 3 years 3 to 5 years More than 5 years

13. What is your current position?:

14. What is your current salary?: Is this figure per week, every 2 weeks, or monthly?: Per week Every 2 weeks Monthly

15. List current Supervisor's name and phone number:

16. Name of Next Previous Employer:

17. How long employed?:

18. List Supervisor's name and phone number:

19. Name of Next Previous Employer:

20. How long employed?:

21. List Supervisor's name and phone number:

22. List your present residence address:

23. What is your monthly payment?:

24. How long have you lived at this address?: Less than 1 year 1 to 2 years 2 to 3 years 3 to 5 years More than 5 years

25. Are you currently renting or buying?: Check one: Renting
Buying If currently renting, list name of landlord and phone number. If buying, list name of the lending institution and phone number:

26. List ALL other residence addresses for the past 5 years: Include address, how long you lived there, landlord name and landlord phone number:

27. List ALL dogs you wish to reside in the rental unit: Include dog name, breed, and weight:

28. List ALL other animals you wish to reside in the rental unit:

29. Have you ever broken a lease agreement by moving before it expired?: Check one: Yes
No If Yes, please provide details. If No, please state you have not broken a lease agreement:

30. Have you ever been evicted from any type of housing or sued for any reason by a former landlord?: Check one: Yes
No If Yes, please provide details. If No, please state you have not been evicted or sued:

31. Have you ever been arrested, charged, or convicted of any crimes or violations of city ordinances?: Check one: Yes
No If Yes, please provide details. If No, please state you have not been arrested, charged or convicted:

32. What vehicles would you keep at the leased premises?: List year and model of ALL vehicles. Indicate if any vehicle has body damage or defective paint:

33. Bank Reference: List name of bank and phone number:

34. List current monthly payments:

35. List other credit references: Companies that you have credit with in the past 5 years. Include name, account number and phone number:

36. By checking this box I specifically authorize the lessor to obtain a credit check on me through a credit reporting agency: Yes, please process my application