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LIST HERE the ADDRESS of the property(ies) you are interested in renting: _______________________________
IDENTIFICATION
Applicant FULL (first, middle, last) name: include any alias Date of birth:
Date of birth:
Co-applicant name: (first, middle, last) name: include any alias
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CURRENT ADDRESS: Unit: City, state, zip:
Mo. rent/pay $
Phone # of applicant: ( )
Mo. rent/pay $
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Co-applicant's employer: Phone: ( ) Mo. gross: $
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Do you have any record of Forcible Entry Detainer (Evictions) or Indebtedness Legal issues: NO or YES
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NOTICE TO APPLICANT:
You application will be screened. Your signature grants permission for any person/agency listed above to release your personal
information for the purposes of renting to you. Screening includes calling your employer(s), references, current and former landlords,
and financial institutions; processing a credit report; checking Public Records; and verifying information on the application. Correct
information: Applicant(s) represent(s) that all of the above statements are true and complete. Applicant(s) acknowledge(s) that giving
false information herein may constitute a criminal offense under the laws of this State. Applicant(s) understand(s) they acquire no
rights in the rental unit until a Holding/Security Deposit is paid when requested by the Landlord/Manager.
Applicant's signature: Date: