RENTAL APPLICATION      Each adult should fill out a separate form.

Address of house you wish to rent

Today’s date

Applicants full name

Phone numbers

Date of birth

Social Security and drivers license number

Current Address

Current Landlords Name, address, number

How long at this address

Reason for leaving

Auto Year, Make, Model, State, lic#

Present Employer

Position

Employers Address

Work phone number

How long at job

Mo. Income

Other income/source

Number and type of Pets

Have you ever been evicted?

Name and location of bank

Type of Account

Give 2 Personal References with name and tel numbers:

Give name and phone numbers of parents:

Names and ages of all occupants

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for tenant screening as may be necessary in arriving at a tenant decision, including obtaining a credit report. I understand that the landlord may terminate any rental agreement entered into for any misrepresentations made above.