7351 Garcia Court, King George, VA 22485

GARCIA ENTERPRISES 7351 Garcia Court, King George, VA 22485 (540775-4805 or (540)775-2706

The below named applicants hereby apply for lease of the following described property, for occupancy beginning on the ______day of ______, 20_____, and ending on the ______day of ______, 20______.

Property Address:

______

Name of Applicant:______SSN______DOB______

Present Address:______

Present Telephone:______

Years There:______Owner’s Name and Phone:______

If less than two years at present address, please give previous address and landlord’s name and address: ______

______

Reason for Moving:______

______

Is applicant(s) currently on active duty in the military service? ______yes or ______no, if yes, which branch ______

Number of persons, sex and age, that will occupy the unit:

______

Pets: NO PETS ALLOWED

EMPLOYMENT VERIFICATION

Present Employer: ______

______

Years There:______Work Number:______

Position:______

Name of Supervisor:______Rental Application (Continued) Page 2

Total Combined Monthly Income:______

Bank Name:______

Account Number:______Type of Account:______

CREDIT REFERENCES

Please list three (3) personal references:

Name:______

Address:______

Telephone:______

Name:______

Address:______

Telephone:______

Name:______

Address:______

Telephone:______

Signature for Credit Check:______