RENTAL APPLICATION (ONE PERSON PER APPLICATION)

Name: ______Phone: ______

Email: ______Former Names: ______

SSN: ______- ______- ______DOB: ______/ ______/ ______

Has your driver’s license ever been suspended, privileges limited or revoked? Yes No

If so, when and why? ______

Current address, including ZIP CODE: ______

Name, address and telephone no. of : ______

______

Length of stay: ______Rent: $ ______Amt. of utilities paid by tenant: $ ______

Reason for leaving: ______

When does your expire? ______Have you given notice? Yes No

When would you like to take occupancy? ______

Former address, including ZIP CODE: ______

Length of stay: ______Reason for leaving: ______

Name, address and telephone number of Landlord: ______

If the total length of the previous two tenancies is less than two years, list additional addresses with ZIP CODE: ______

______

Names of all adult co-tenants: ______

Pets: Number ______types: ______weight: ______and ages: ______

Number of vehicles: cars: ______trucks: ______other: ______

Plate numbers: ______

Current employer: ______Phone: ______

Position:______Length of employment: ______NET pay per mo: $ ______

Additional income: Amount $ ______Source: ______

Total of ALL monthly debt, excluding rent and utilities listed above $ ______

Page 1 FORM PROVIDED BY SCREENING SERVICES INC. CALL 440.230.2929 OR 855-OK2RENT. RENTAL APPLICATION (ONE PERSON PER APPLICATION)

Personal reference: (List name, address, telephone number and relationship) ______

______

Emergency information: (List name, address, telephone number and relationship) ______

______

If you could not meet your financial obligations, who would you turn to for help? ______

Do you currently carry renter's insurance? Yes No Amount: $ ______

Company name: ______

Does anyone in your household smoke? Yes No

Have you ever been served an notice or have you been asked to leave a rental ? Yes No

If so, when? ______and why? ______

List the Landlord's name, address and telephone number: ______

Have you ever deposited rent with a court or refused to pay your rent when it was due? Yes No

If the answer is yes, please explain: ______

Have you ever been convicted of a felony? Yes No

If so, list the charge, year, county and state: ______

Have you ever filed bankruptcy? Yes No If so, when? ______

Has it been discharged? Yes No If yes, when? ______

What type of bankruptcy? Chapter 7 Chapter 13

Have your wages ever been garnished? Yes No If so, when and why ______

Are you currently a co-signer on a loan? Yes No

I certify that all of the information listed above is truthful and complete. I give permission for a CREDIT REPORT AND CRIMINAL ECORD SEARCH to be run for tenant screening purposes. THE TENANT RELEASE FORM MUST ACCOMPANY THIS APPLICATION.

Signature: ______Date: ______

Page 2 FORM PROVIDED BY SCREENING SERVICES INC. CALL 440.230.2929 OR 855-OK2RENT.