<p> Return to: Jan Gagne Ph# (541) 829-1080 RENTAL APPLICATION For (Rental Address)______Neatly complete all information below. All other applicants over the age of 18 must complete and sign their own application.</p><p>Primary Applicant ______Phone #______DOB______</p><p>Social Security #______Drivers License #______State______Exp.______</p><p>Current Address______City______State_____Zip______</p><p>Current Landlords Name______Phone #______</p><p>How long at this address______Reason for leaving______</p><p>Previous Address______City______State_____Zip______</p><p>Previous Landlords name______Phone #______</p><p>How long at this address______Reason for leaving______</p><p>Auto Yr._____Make______Model______State/License plate #______</p><p>Present Employer______Position______Phone #______</p><p>Employers Address______City______State_____Zip______</p><p>Phone #______How long at this job______Mo Income______</p><p>Other Income/sources______</p><p>Co-applicant______DOB______</p><p>Social Security #______Drivers License #______State______Exp.______</p><p>Present Employer______Position______Phone #______</p><p>Employers Address______City______State_____Zip______</p><p>Phone #______How long at this job______Mo Income______</p><p>Other Income/sources______</p><p>Number and type of pets______Have either of you ever been party to an eviction? [ ] Yes [ ] No</p><p>Total number of adults______Total number of children living with you under the age of 18______</p><p>Names and relations of all other applicants______</p><p>______</p><p>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 tenet 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 misrepresentation made above.</p><p>Signature______Date______Return to: Jan Gagne Ph# (541) 829-1080 Signature______Date______</p>