* Applicants Name:
Other names used in last 10 years(maiden or married):
* Email Address: * Home Phone:
Work Phone: Cell Phone:
* Drivers License#: in * [Select State] Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Mississippi Missouri Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Washington Wisconsin West Virginia Wyoming
* Date of Birth: Height: Weight: Eye Color:
Hair Color: Marital Status: * US Citizen: Yes No

* Choose one:Own Home Parents Home Rented Home Rented Apartment Student Housing Other
* Current Address:
* City: * State: [Select State] Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Mississippi Missouri Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Washington Wisconsin West Virginia Wyoming * Zip:
* Owner or Managers Name: * Phone#:
* Current Rent $: * Date Move In: * Date Lease Ends:
* Reason for leaving:
* Is landlord a family member: Yes No * Have you given notice to vacate: Yes No

* Employer:
* Address:
* City: * State: [Select State] Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Mississippi Missouri Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Washington Wisconsin West Virginia Wyoming * Zip:
* Type of Work: * Position Held:
* Supervisor: * Phone#:
* Monthly gross income: * Start Date:
* Still Employed: Yes No
* Describe other income Applicant wants considered:

* 1. Make / Model: Year: Color: License Plate#:
2. Make / Model: Year: Color: License Plate#:
3. Make / Model: Year: Color: License Plate#:

1. Type & Breed: Age: Weight:
2. Type & Breed: Age: Weight:
3. Type & Breed: Age: Weight:

Does anyone who will occupy the Property smoke? Yes No
Will Applicant maintain renter's insurance? Yes No
Is Applicant or Applicant's spouse, even if separated, in the military? Yes No
Has Applicant ever been evicted? Yes No
Has Applicant been asked to move out by a landlord? Yes No
Has Applicant breached a lease or rental agreement? Yes No
Has Applicant filed for bankruptcy? Yes No
Has Applicant lost property in a foreclosure? Yes No
Has Applicant had any credit problems? Yes No
Has Applicant been convicted of a crime? Yes No
Is any occupant a registered sex offender? Yes No
Are there any criminal matters pending against any occupant? Yes No
Do you owe another property money? Yes No

Please list all occupants for the home including residents staying 2 or more days a week.

* 1. Name: Relationship: D.O.B.:
2. Name: Relationship: D.O.B.:
3. Name: Relationship: D.O.B.:
4. Name: Relationship: D.O.B.:
5. Name: Relationship: D.O.B.:

Applicant represents that the statements in this application are true and complete. Providing false or inaccurate information is grounds for rejection and breach of your lease.
Notice: The property will remain on the market until a Security Deposit is received and/or a lease is signed. The owner/manager may continue to show the property to other prospective tenants.

I ACKNOWLEDGE THAT I HAD AN OPPORTUNITY TO REVIEW THE PROPERTY'S RENTAL SELECTION CRITERIA, WHICH INCLUDES REASONS WHY MY APPLICATION MAY BE DENIED, SUCH AS CRIMINAL HISTORY, CREDIT HISTORY, CURRENT INCOME, AND RENTAL HISTORY. I UNDERSTAND THAT IF I DO NOT MEET THE PROPERTY'S RENTAL SELECTION CRITERIA OR IF I FAIL TO ANSWER ANY QUESTIONS OR GIVE FALSE INFORMATION, THE PROPERTY MAY REJECT THE APPLICATION, RETAIN ALL APPLICATION FEES, AND DEPOSITS AS LUQUIDATED DAMAGES FOR ITS TIME AND EXPENSE, AND TERMINATE ANY RIGHTS OF OCCUPANCY.