Content copyright . Brooks and Broadwell Realty. All rights reserved.
Applicant Info.
First Name: ______________________ Last Name: __________________________
SSN: _________-______-___________ Birthday: __________/_________/________
Phone (_______) _________________ Cell: (________)______________________
License # _________________________ Smoke?: Yes_________ No___________
Co-applicant Info.
First Name: ________________________ Last Name: _________________________
SSN: _________-________-_________ Birthday: _________/________/_________
Phone(_______)___________________ Cell: (_______)______________________
License # _________________________ Smoke?: Yes_________ No ___________
Others who will be living with you
Name:______________________________ Relationship: ______________ Age: ______
Name:______________________________ Relationship: ______________ Age: ______
Name:______________________________ Relationship: ______________ Age: ______
Name:______________________________ Relationship: ______________ Age: ______
Current Address
Address: ________________________________________________________________
City:
Manager: ___________________________ Phone (________)_____________________
Start date: __________/_________/__________ End Date: __________/_______/_____
Leave Reason: ___________________________________________________________
Past Rental History
Address: ________________________________________________________________
City:
Manager: ______________________________ Phone: (_________)________________
Start Date: _______/________/________ End Date: _________/_______/_________
Leave Reason: ___________________________________________________________
Employment History
Company: _______________________________________________________________
Manager: ____________________________ Phone: (________)___________________
Address: ________________________________________________________________
City:
Emp Length: ______________________ Monthly Pay: ___________________________
Co-Applicant Employment History
Company: _______________________________________________________________
Manager: ____________________________ Phone: (_______)____________________
Address: ________________________________________________________________
City:
Emp Length: _______________________ Monthly pay: __________________________
Additional Income
Income Source: _________________________________ Amount: _________________
Verify with: ______________________________Phone (_________)_______________
Personal References
Name:_______________________ Relationship:_____________ Phone:_____________
Name:_______________________ Relationship:_____________ Phone:_____________
Name:_______________________ Relationship:_____________ Phone:_____________
Automobile Information
Make:______________________ Model:__________________ Plate #: _____________
Make:______________________ Model:__________________ Plate #: _____________
Pet Information
Type: _______________________ Breed: _________________ Weight: ____________
Type: _______________________ Breed: _________________ Weight: ____________
Additional Information
Have you ever been convicted of a crime? _____________________________________
Describe and date each one. ______________________________________
________________________________________________
________________________________________________
Have you ever been evicted, declared ______________________________________
Bankruptcy or had a judgement? ______________________________________
Describe and date each one. _____________________________________________
_____________________________________________
________ I agree to the following statement
I represent that the information provided in this application is true, complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for rejection of this application and for eviction.
________ I agree to the following statement
I understand that the information provided might be used by Landlord to determine whether to accept this application. I authorize Landlord to verify all the information given in this application, including past rental information, personal references and employment information provided. I authorize the Landlord to obtain a current credit and criminal background check.
_________ I agree to the following statement
I understand that this application is not a rental agreement and that this application does not create any obligation on the Landlord. If any information obtained causes my application to be rejected, I understand that information may not be disclosed to me. Agent has the responsibility to offer equal service to all prospects without regard to race, color, religion, sex, handicap, familial statue or national origin. You are hereby advised that this agent and firm represent the owner and/or signature below acknowledges that this information has been disclosed to you. I understand there is a $30.00 application fee to pay with this application.
Print Name: _____________________________________
Signature: ______________________________________Date: ______/_______/_____
Print Name: _____________________________________
Signature: ______________________________________Date: ______/_______/_____
