REAL ESTATE RENTAL FORM
Application and Verification

RENTAL APPLICATION / FUTURE HOMEBUYER
(Suggested questions to ask every applicant age 18 or older)

Today's Date: _________________________ Occupancy Date Desired: _______________________          

Rental Price Range: ____________________ Type/Size Desired: _____________________________

Rental Address Shown: _______________________________________________________________

APPLICANT'S PERSONAL INFORMATION
Last Name:______________________ First:_______________________ Middle:________________      

Birthdate:__________________  Driver's License/ID Number/State: ___________________________            

Social Security #:_______________________Email address: _________________________________

Additional Occupants (List every occupant name and their relationship below, including children)

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Preferred Method of "Worry-Free" Standard Rental Payments:
Electronic Banking _____ Payroll Deduction _____ Charge Card _____ Debit Card _____
Other method of payment which requires additional $_____ handling fee: Check ___ Money Order ___

Preferred type of rental desired: Standard _____ Customized _____ Deluxe _____
Preferred Rental Due Date:
Old Fashion Method - Monthly ___  Pay Day Plan - Bi-Weekly ___  Other Alternative - Weekly ___

How long do you plan on living in the next rental home that meets your needs? ___________________
Would you like to receive a rental gift on your anniversary dates as part of a "3 Star Resident Program"? _____
Would you like to purchase a home within the next 2 to 3 years?______ If so, what size/type property would you like to buy? ___________________________________________________________
Would you be interested in our Future Home Buyers Program to help you find and buy your first home?
Are you able to handle all the minor maintenance/upkeep in the property
Yes ___ No___. Check the following items that you own -
Vacuum Cleaner ___ Mop ___ Broom ___ Plunger ___ Lawn Mower ___
Appliances (if so, which ones) ____________________________________
Please note: Residents who handle minor maintenance and repairs on the property and pass property inspections are eligible to receive credit to help purchase a future home (that's part of our future homeowners program).
Check all professional level skills possessed:  Electrical ____ Painting ____ Plumbing ____

Roofing ____ Appliance repair ____ Air Conditioning ____  Heating ____ Carpentry ____

Do you have renter's insurance? _____________ Do you have any water-filled furniture? _____________
Have you ever broken a lease? _________ Have you ever refused to pay rent for any reason? __________
Have you ever been evicted or asked to leave a rental unit? _______ Ever filed for bankruptcy? _________
Ever been convicted of a crime ____ Will you give us permission to do a criminal background check? _____
Currently have any utilities in your name? ______    Currently have phone service in your name? _______

Is there anything to prevent you from placing utilities or phone in your name? _____________________
Do you know of anything or any reason which may interrupt your ability to pay rent? ______________

RESIDENCE HISTORY
Present Street Address ______________________________________________________________
City _________________________________ State _______________ Zip ____________________ 

Dates lived at this address?_____________________________ Own ____ Rent ____ Occupy _____

Current Phone _______________________  How many pets did you have? _____ Type___________
Name of present landlord/owner/mortgage company: ________________________________________
Address of present landlord/mortgage company: ___________________________________________
Landlord's phone: ____________________________ Monthly payment: _______________________
Reason for moving:____________________________ Is your rent/mtg current? __________________
Number of late payments? __________ Security Deposit Amount currently held by landlord? _______

Previous Residence Address: __________________________________________________________
Previous landlord:_________________________ Previous landlord's phone:_____________________

Dates at this address:_______________________Reason for moving?___________________________
Was your Full Security Dep. Returned?______ # of late payments? ____ Monthly payment? ________

Previous Residence Address: __________________________________________________________

Previous landlord:_________________________ Previous landlord's phone:_____________________

Dates at this address:_______________________Reason for moving?___________________________
Was your Full Security Dep. Returned?______ # of late payments? ____ Monthly payment? ________ 

INCOME HISTORY                                                                                                                              

Applicant's current employment status:

Full-time _____ Part-time (less than 32hrs) _____ Student _____ Retired _____ Self-employed _____
Unemployed ______ Other _________________________________________________________

Primary source of employment:
Applicant employed by: ______________________ Supervisor's name:______________________
Average Weekly hours:_______________ How long at they place of employment? ______________
Address:_______________________________________________________________________
City:__________________________________________ State: ________ Zip: _______________            

Phone: ________________ Position:________________________ Salary: ___________________
Please indicate Weekly, Bi-Weekly, Monthly, or Annual Average Take home:___________________

Additional Employment
Employed by:_____________________________ Supervisor's name:________________________
Average Weekly hours:_______________ How long at they place of employment? ______________
Address:_______________________________________________________________________
City:__________________________________________ State: ________ Zip: _______________             

Phone: ________________ Position:________________________ Salary: ___________________
Please indicate Weekly, Bi-Weekly, Monthly, or Annual Average Take home:___________________

ADDITIONAL INCOME / PAYMENT INFORMATION
In the event of some emergency that would prevent you from paying rent when due, is there a relative, person, or agency that could assist you with rent payments?
1st Emergency Contact: __________________________________________________________
Relationship ___________________________________________________________________
Address______________________________________________________________________
_____________________________________________________________________________
Phone# __________________________________ 2nd Phone #___________________________

2nd Emergency Contact: __________________________________________________________
Relationship ___________________________________________________________________
Address______________________________________________________________________
_____________________________________________________________________________
Phone# __________________________________ 2nd Phone #___________________________
Do you currently have a savings account, line of credit, or charge card sufficient to cover one month's rent? _________________________________________________________________________

ADDITIONAL INCOME: (optional)
If there are additional, verifiable sources of income you would like considered, Please list income source (i.e., self-employment, social security, benefit payments, etc.), and requested information below regarding each source. Applicant may be required to produce additional documentation or provide and sign release statements. Child support, alimony, or separate maintenance need NOT be disclosed unless you desire this additional income to be considered for qualification.

Additional Source:____________________________________ Amount:$_______ Per__________           

Contact person: ____________________________________ Phone:________________________
How long have you been receiving income from this source?____ How long do you expect this income continue?

_____________________ Is there any reason it would stop?________________________

Additional Source:____________________________________ Amount:$_______ Per__________           

Contact person: ____________________________________ Phone:________________________
How long have you been receiving income from this source?____ How long do you expect this income continue?

_____________________ Is there any reason it would stop?________________________

ASSETS / CREDITS / LOANS
Number of vehicles on property? ___________ Valid registration & inspection? __________________
Do you have any commercial vehicles, ___________  RV, campers, boats or motorcycles? _________           

Vehicle 1-make/model/color/year________________________________________________________
Please note, only cars on application are authorized to be on premises.
Plate number_______________________________________ State ___________________________
Financed/leased through ______________________________________________________________         

Contact and phone number____________________________________________________________               

Acct. # _______________________________________ Monthly payment ____________________

Vehicle 2-make/model/color/year_______________________________________________________
Please note, only cars on application are authorized to be on premises.
Plate number_______________________________________ State __________________________
Financed/leased through _____________________________________________________________         

Contact and phone number___________________________________________________________              

Acct. # _______________________________________ Monthly payment ____________________

CREDIT CARDS, LOANS (including banks, department store, gas cards, student loans)
Creditor:___________________________________________________________________________
Address ___________________________________________________________________________
Phone: _____________________ Acct. #: ________________________________________________
Total Amount owed:___________ Monthly payment:__________ Are your payments current?______

Other Creditor:_____________________________________________________________________
Address ___________________________________________________________________________
Phone: _____________________ Acct. #: ________________________________________________
Total Amount owed:___________ Monthly payment:__________ Are your payments current?______                                                                                                                                                             

List any other current monthly expenses?
Hospital payment ____________ Health Insurance _____________ Auto Insurance _____________           

Renter's Insurance ____________ Child care __________________ Tuition ___________________
Cable TV __________________ Other _______________________ Amount __________________

BANK REFERENCE

Name of bank and branch:_________________________________Phone:______________________
Branch address:_____________________________________________________________________
Checking Acct. #:____________________________________________________________________
Savings Acct#:______________________________________________________________________
How long account active, (C)_____  (S)_____ Average monthly balance, (C)_________ (S) _________

PERSONAL/PROFESSIONAL REFERENCES
Character/Personal reference:
Name____________________________________________________________________________
Address___________________________________________________________________________
City _______________________________________ State ________ Zip ______________________
Relationship?________________________ How long? ______________ Phone __________________

Professional reference (i.e. attorney, accountant):
Name____________________________________________________________________________
Address__________________________________________________________________________
City ______________________________________ State ________ Zip ______________________
Relationship?________________________ How long? ______________ Phone _________________
Name of Nearest Living Relative:
Name____________________________________________________________________________
Address__________________________________________________________________________
City ______________________________________ State ________ Zip ______________________
Relationship?________________________ How long? ______________ Phone _________________

Name of Doctor or Health Care Provider:
Name____________________________________________________________________________
Address__________________________________________________________________________
City ______________________________________ State ________ Zip ______________________
Relationship?________________________ How long? ______________ Phone _________________

Do you give owner or manager permission to contact references listed above both now and in the future for rental consideration or for collection purposes should they be deemed necessary?_______________

If Management has a question regarding this application, please furnish the best contact phone number:
Day phone/contact person:___________________________________________________________
Night phone/contact person:__________________________________________________________

THANK YOU!

Thank you for completing an application to rent from us. Please sign below. Please note that a completed application requires submission of the following which will be copied and attached to this application:                                          

__ Driver's License or Sheriff's picture ID. Note: rentals will not be shown without picture ID
__ Personal check (to verify bank)  __ 2 weeks of most current pay stubs of each income source listed  

__ If self-employed, most current Schedule C tax return and proof of current income

A fee of $ ________ is charged on all rental applicants for the purpose of verifying the information furnished on this application. By signing below, applicant hereby represents all information on this application is true, complete, and hereby authorizes annual verification of information, references, and credit history for continual rental consideration or for collection purposes should that become necessary. This fee is refundable / nonrefundable / or only refundable if applicant meets our minimal criteria but is not selected because they were not the first qualified applicant.

Applicant acknowledges this application will become part of the lease agreement when approved. If any information is found to be incorrect, the application will be rejected and any subsequent rental agreement becomes void. False and misleading statements will be sufficient reason for immediate eviction and loss of security deposit.

FREE UPGRADE BONUS                                                                                                                               

Final note: Our company offer a free upgrade for residents who recommend friends, relatives or co-workers to us and they meet our minimum criteria and decide to rent from us or be placed on our priority waiting list. If your application is accepted, you may be able to qualify for a free upgrade in your new residence. Please give the name of a friend, relative or co-worker along with a phone number and we will contact them to see if they too would like to apply and rent one of our homes. The following person(s) may be interested in renting a home:
___________________________________________________________Phone______________________
___________________________________________________________Phone______________________

Applicant's signature:________________________________________ Date:________________________