Application For Rent Choose Side: Personal Information Residence History Employment and Income History Credit Information Personal References Personal Information Application to rent property at (required) Full name of applicant (required) Date of birth Social security No. Driver's license No. Phone number (required) Your Email Address (required) Name(s) of all other proposed occupant(s) and relationship to applicant Pet(s) or service animals (number and type) Does applicant or any proposed occupant plan to use liquid-filled furniture? YesNo Type: Has applicant been a party to an unlawful detainer action or filed bankruptcy within the last seven years? YesNo If yes, Explain Has applicant or any proposed occupant ever been convicted of or pleaded no contest to a felony? YesNo If yes, Explain Has applicant or any proposed occupant ever been asked to move out of a residence?YesNo If yes, Explain Residence History Current Address (required) From: To: Name of Landlord/Manager (required) Do you own this property? YesNo Reasons for leaving current address Previous address: From: To: Name of Landlord/Manager: Did you own this property? YesNo Reasons for leaving current address Employment and Income History Current Employer's Name (required) Employer's Address (required) Position or Title Employment gross income $ per Supervisor (required) Supervisor's Phone Number (required) Credit Information Please list outstanding debt 1st Creditor Name of creditor: Account number: Monthly Payment: Balance Due: 2nd Creditor Name of creditor: Account number: Monthly Payment: Balance Due: 3rd Creditor Name of creditor: Account number: Monthly Payment: Balance Due: Bank Account Information Bank #1 Name of Bank: Account Number: Type of Account: Account Balance: Bank #2 Name of Bank: Account Number: Type of Account: Account Balance: Personal References Person #1 Name: Address: Phone Number: Length of acquaintance: Relation to applicant: Person #2 Name: Address: Phone Number: Length of acquaintance: Relation to applicant: Questions? By typing my name and initials below, I authorize Michael Berdelis's office to run my credit, to determine my credit worthiness, and I acknowledge that the information provided in this application is true under penalty of perjury. Full name: Initials:
