Rental Application - Mississippi Alternative Housing Program Page 2
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4Spouse's Name _ _ _ _ _ _ _ _ _ Position _ _ _ _ _ _ l\1onthly Salary $ _ _ _
Supervisor's Name _ _ _ _ _ _ _ _ _ _ _ Telephone
Number~======
If spouse employed by above less than 6 months, give name, address, and telephone# of
previous~ploy~orschool
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
~
Other Income: $ _ _ _ _ _ Source~·
==========================
NAMES OF OCCUPANTS (All persons occupying
pr~ises
must be listed)
Name
Relationship
Date of Birth
EMEGENCY CONTACT _ _ _ _ _ _ _ _ _ Relationship-------
Address
Telephone Number _ _ _ _ _ _ _ _
PLEASE LIST YOUR BANK AND CREDIT REFERENCES
Bank _ _ _ _ _ _ _ _ _ _ _ City/State _ _ _ _ _ Checking Acct. # _ _ _ _ _
Bank _ _ _ _ _ _ _ _ _ _ _ City/State _ _ _ _ _ Checking Acct. # _ _ _ _ _
Credit Reference: _ _ _ _ _ _ _ _ _ _ Telephone Number _ _ _ _ _ _ _ _ _ _
Credit Reference: _ _ _ _ _ _ _ _ _ _ Telephone Number _ _ _ _ _ _ _ _ _ _
AUTOlviOBILE INFORNIATION
l\1ake _ _ _ _ _ _ _ _ _ Color _ _ _ _ Year _ _ Tag Number _ _ _ _ _ _ _
Make _ _ _ _ _ _ _ _ _ Color _ _ _ _ Year _ _ Tag Number _ _ _ _ _ _ _
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Parent category: Business