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RENTAL APPLICATION For 110 Schmittle Road Neatly complete all information below. All applicants over the age of 18 must complete and sign their own application. Today's Date________________________________________ Applicants full name___________________________________Phone #___________________DOB__________ Social Security #____________________Drivers License #____________________State________Exp.________ Current Address________________________________City___________________State________Zip_________ Current Landlords Name__________________________________Landlords Phone # ______________________ How long at this address__________Reason for
leaving______________________________________________ Previous Address________________________________City___________________State_______Zip_________ Previous Landlords Name__________________________________________Phone #______________________ How long at this address__________Reason for leaving______________________________________________ __________________________________________________________________________________________ Present Employer_____________________________Position__________________Mo. Income______________ Phone #__________________How long at job_________Other income/source____________________________ Employers Address_________________________________________City___________________State________ Number and type of Pets___________________________Have you ever been party to an eviction? [ ] Yes [ ] No Name of bank_________________________Branch_____________________Type of Account_______________ Name of bank_________________________Branch_____________________Type of Account_______________ Personal References (at least two) Name______________________________Yrs. Known____Relationship____________Phone
#______________ Name______________________________Yrs. Known____Relationship____________Phone
#______________ Name______________________________Yrs. Known____Relationship____________Phone
#______________ Total number of adults___________Total number of children living with you under the age of 18_____________ Names and relations of all other applicants/occupants__________________________________________________ ___________________________________________________________________________________________ Terms of this Rental Agreement (updated 10-14 2006)Rent: $450.00 plus utilities: Gas and Electric Rent due: By 10th day of
each month. Damage Deposit: $450.00 due with first month's
rent (may be applied to final month's rent)
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, I understand that the landlord may terminate any rental agreement entered into for any misrepresentations made above. Signature________________________________________________________________Date____________________ Second Occupant Signature__________________________________________________Date____________________
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