Humboldt Property Management Page 2
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2954 H Street
Humboldt Property Management
Arcata, CA 95521 U.S.A.
(A division of Humboldt Realty, Corp)
Main Office: (707) 825-1515
Fax: (707) 825-1558
Email:
Residential * Commercial * Lt. Industrial
If employed less than six months give previous employer or school:
_______________________________________________________________________________________
___________________________________________________
If there are other sources of income you would like considered, please list income & source. You do NOT
have to reveal alimony, child support unless you wish us to consider it. If you are a student receiving
parental or financial aid, please list it.
AMOUNT $_________________________ SOURCE OF INCOME:__________________
PLEASE LIST YOUR BANK & CREDIT REFERENCES
BANK NAME (S)
CITY & STATE
TYPE ACCT.
1. ___________________________________________________________________________
2. ___________________________________________________________________________
CREDIT REFERENCES
CITY & STATE
TYPE ACCT.
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
YOUR DRIVERS LICENSE NUMBER & STATE:_________________________________________
VEHICLE MAKE/MODEL:_____________________YEAR:_______LICENSE#:________________
OTHER VEHICLES:_______________________________________________________________
HAVE YOU EVER:
Filed for Bankruptcy?
Yes
No
Been evicted from tenancy?
Yes
No
Willfully or intentionally refused to pay rent when due?
Yes
No
Broken a lease?
Yes
No
Rented from Humboldt Property Management?
Yes
No
PLEASE GIVE ANY ADDITIONAL INFORMATION WHICH MAY HELP MANAGEMENT EVALUATE THIS
APPLICATION (including personal references) ____________________________________
IN CASE OF EMERGENCY, PERSON TO NOTIFY:______________________________________
Relastionship:___________________________ Phone:________________________________
Complete Address:_____________________________________________________________
I recognize that as a part of your procedure for processing my application, a credit report will be drawn and
an investgative consumer report may be prepared whereby information is obtained through personal
interviews with my neighbors, friends, employers, or others with whom I may be acquainted. This inquiry
includes information as to my character, general reputation, personal characteristics, and mode of living.
Applicant understands that the landlord may terminate any rental agreement entered into for any
misrepresentation made above.
The above information, to the best of my knowledge, is true and correct.
Signature of Applicant:_________________________________Date Signed:________________
Signature of Spouse:___________________________________Date Signed:________________
Day Phone:______________________ Evening Phone:__________________________
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