D’Alessandro H ouse B uyers
753 G enesee S treet
Rochester, N Y 1 4611
Phone: 5 85-‐302-‐4297
Fax: 5 85-‐563-‐6095
Property Location:
Move In Date:
Applicant Information
First Name:
MI:
Last:
Date of Birth:
Phone:
Email:
Vehicle Color, Make, Model and Plate:
Current Address:
Current Landlord:
Phone:
How Long:
Monthly Rent:
Previous Address:
Previous Landlord:
Phone:
How Long:
Monthly Rent:
Have you ever been evicted:
Yes
No
Have you ever been arrested:
Yes
No
Current Employer:
How long:
Position:
Supervisor:
Phone:
Reason you are moving?
How did you hear about us?
Craigslist
Friend:
Do you have a pet? Describe:
I authorize the verification of the information provided on this form:
Signature of Applicant:
Date:
Do you have a deposit (1 month’s rent) ready to hold house/apt?
YES
NO
***Please include a copy of your photo id and proof of income with application.
***If you are unable to provide proof of income please fill out and submit the co-
signer application.
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