Rental Application Form Page 2
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1
2Employment History:
(All current employment & complete Verification of Employment for each -VOE)
6
(Applicant)
Employer: _________________________________
Phone:___________________
Monthly Income $____________
(Spouse)
Employer: _________________________________
Phone:___________________
Monthly Income $____________
nd
(2
Job)
Employer: _________________________________
Phone:___________________
Monthly Income $____________
Total Monthly Employment Income:
$
Other Income:
((Provide supporting documents)
7
__ -Pension __ -Social Security/Disability __ -Alimony/Child Support __ -Unemployed/Workers Comp
__ -TANF __ -GI Bill __ -Student Loans
__ -Other Description: ________________________
$
Total Monthly Other Income:
Asset:
(Provide 6 months of statements)
8
Checking Account? __ -Yes __ -No
Savings Account? __-Yes __ -No
Money Market? __-Yes __-No
Trust Account? __-Yes __ -No
Other Accounts? __-Yes __ -No
Occupants: ((
in unit)
(List all persons to live in unit)
9
Number of Persons to Live in Unit: __________________ (include self)
First
Last
Sex
DOB
Ethnicity
SS#
Custody %
_______________
_______________
___
____/____/____
________________
_____/_____/_____
__100__%
_______________
_______________
___
____/____/____
________________
_____/_____/_____
_______%
_______________
_______________
___
____/____/____
________________
_____/_____/_____
_______%
_______________
_______________
___
____/____/____
________________
_____/_____/_____
_______%
_______________
_______________
___
____/____/____
________________
_____/_____/_____
_______%
_______________
_______________
___
____/____/____
________________
_____/_____/_____
_______%
Transportation:
10
What is your mode of transportation?
-Own Auto
-Public Transportation
-No Transportation
__
__
__
1) Make: ____________ Model: _______________ Color:_______ Year: ______ License: __________
State:____
2) Make: ____________ Model: _______________ Color:_______ Year: ______ License: __________
State:____
Emergency Contact:
11
Name: ____________________________________ Phone #: (_____)______________ Relationship:____________
Address: ________________________________________ City:_______________________ ST:_______ Zip:________
E-mail Address: _______________________________________
Other:
12
Do you owe any unpaid rent?
__ -No
-Yes
Date: ______________
__
Have you ever violated a lease, rental agreement?
__ -No
-Yes
Date: ______________
__
Have you been sued for damage to rental property?
__ -No
-Yes
Date: ______________
__
Have you ever been evicted or asked to move out?
__ -No
-Yes
Date: ______________
__
Have you ever filed for bankruptcy?
__ -No
__ -Yes
Date: ______________
Do you have a criminal record?
__ -No
-Yes
Date: ______________
__
Please explain:______________________________________________________________________________
-No
-Yes Special accommodations needed?_________________
Are you disabled or handicapped? (optional) __
__
Have a Pets? __ -No __ -Yes # ______
Hgt.: ________
Wgt.:________
Description:_________________
__ -Single __ -Couple __ -Female Single Parent __ -Male Single Parent __ -Couple w/child(ren)
__ -Own home __ -Renter __ -Motel __ -With family __ -With friends __ -Outdoors __ -Auto __ -Trans. Shelter __ -Jail
-No
-Yes Have you served in the military? __-No
-Yes
Are you a full time student? __
__
__
13
Authorization:
As a part of our procedure for processing your application, an investigative consumer report may be prepared whereby information is
obtained through personal interviews with your landlord, employer, others with whom you are acquainted, a credit check, and criminal report.
By signing below you authorize this process. The applicant understands that approval of this application is conditional upon the information
supplied in the above mentioned consumer report meeting lease criteria. I/We certify that the information herein is TRUE and CORRECT, that
this application is submitted for the purpose of inducing approval of this application in my/our behalf, and any errors in this application may be
used by Greccio Housing and /or agent to terminate the lease at any time. This application information may be released/used for the purpose of
collecting any monies due Greccio Housing.
____________________________________________
__________________________
Applicant, Co-Signer, or Roommate Signature
Date
__________________________________________
_________________________
Spouse Signature
Date
RF03 (05/01/12)
Mail: 1808 W. Colorado Ave., Colorado Springs, CO 80904 Tel: 719-475-1422 Ext. 104 Fax: 719-578-0030 Web:
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