<p> RENTAL APPLICATION Only Clean Responsible People Who Pay Rent On Time Need Apply</p><p>Name Current Address How Long There Home Telephone # Work Telephone # Cell # Birthdate May we contact you through email Yes NO E-Mail Address ______Driver’s License # Social Security # Date you would like to move In______Employment: Full time Part Time Self Employed Student Retired Unemployed Current Employer/Company Name How Long There Your Position/Title Employer Address Immediate Supervisor Name Immediate Supervisor phone # Gross Salary (Wk/Mo/Yr) Date Hired If retired please provide the following information as income: Pension income per month Social Security income per month Sources of Income</p><p>List all others to occupy premises including children, relatives and others not listed above (Name & Birthdate).</p><p>List Vehicle(s) you and co-tenant(s) have: Type Vehicle Color Year Model License Plate #</p><p>Rent at Present Address $ Includes: ( ) Gas ( ) Electric ( ) Heat ( ) Water ( ) Furniture Reason for Leaving Date Moved In Date Moved Out Landlord Name & Telephone # Landlord Address </p><p>Pets – Name Type Breed Weight Color Age It is clearly understood that no pets are allowed on premises at any time unless otherwise agreed to by the landlord in writing. NO EXCEPTIONS. Have you ever been sued for nonpayment of rent YES NO Have you ever been asked to move out or served an Eviction notice YES NO Have you ever filed bankruptcy YES NO</p><p>Have you ever been sued for sued for damage to rental property YES NO Have you ever broken a rental agreement YES NO Have You ever been convicted of a crime YES NO If yes please list below: ______Nearest Living Relative in area: Name Address & Telephone # Nearest Friend in Area: Name Address & Telephone # Parents: Name Address & Telephone # Co-Applicant information:</p><p>Name Current Address How Long There Home Telephone # Work Telephone # Cell # Birthdate May we contact you through email Yes NO E-Mail Address ______Driver’s License # Social Security # Employment: Full time Part Time Self Employed Student Retired Unemployed Current Employer/Company Name How Long There Your Position/Title Employer Address Immediate Supervisor Name Immediate Supervisor phone # Gross Salary (Wk/Mo/Yr) Date Hired If retired please provide the following information as income: Pension income per month Social Security income per month Sources of Income</p><p>Have you ever been sued for nonpayment of rent YES NO Have you ever been asked to move out or served an Eviction notice YES NO Have you ever filed bankruptcy YES NO Have you ever been sued for sued for damage to rental property YES NO Have you ever broken a rental agreement YES NO Have you ever been convicted of a crime YES NO If yes please list below: ______Nearest Living Relative in area: Name Address & Telephone # Nearest Friend in Area: Name Address & Telephone # Parents: Name Address & Telephone # </p><p>I declare the above application information to be true and that the owner/manager may immediately terminate any tenancy entered into in reliance upon misinformation given on this application.</p><p>By signing this application, I agree to rent this unit (if application is approved) and agree that if I am accepted by the landlord and I change my mind and do not move into the premises, the sum of one month’s rent and any application fees/deposits will be forfeited as liquidated damages since other prospective tenants will have been turned away, and it will be necessary for the landlord to readvertise the property and re-evaluate other tenants.</p><p>The applicant recognizes and authorizes the owner or his agent to investigate information regarding my character, general reputation, personal character references, mode of living, and credit standing and a full disclosure of pertinent facts may be made to the owner. The owner may also require a credit report form a credit reporting agency (Credit report to be obtained by Preferred Mortgage Corp) and by signing this application, I authorize full disclosure to landlord.</p><p>Applicant Date</p><p>Co-Applicant Date</p><p>Application Deposit Submitted $ Check # Date </p>