Rental Application
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1
2RENTAL APPLICATION
ERSONAL
P
Date:
Applicant
Last Name
First Name
M.I.
Social Security No.
Date of Birth
Co-Applicant
Last Name
First Name
M.I.
Social Security No.
Date of Birth
Present address
Street Address
City
State
Zip Code
Home Phone
Cell Phone
Email address
No. of autos
Reg. no. of auto no. 1
Reg. no. of auto no. 2
No. of occupants (total)
Specify: Adults
Children:
D.O.B. of children: No. 1
No. 2
No. 3
Month/Year
Month/Year
Month/Year
No. of pets
Types/Breeds
In case of emergency, notify:
Relationship
Address
Street Address
City
State
Phone
Are there any special accommodations that the household will require in order to enjoy equal opportunity to use and enjoy the residence?
Example: unit for mobility impaired, visually impaired, hearing impaired or other.
Check one:
Yes
No If yes, you will be asked to complete a Request for Reasonable Accommodation.
RESIDENCY AND EMPLOYMENT
Own:
Date of current occupancy from
to
$
Month/Year
Month/Year
Monthly mortgage payment
Rent:
Date of current occupancy from
to
$
Month/Year
Month/Year
Monthly rent payment
Present landlord, if applicable
Name
Address
Phone
Former landlord, if applicable
Name
Address
Phone
Currently employed by
Occupation
Address
Street Address
City
State
Zip Code
Length of employment
Supervisor
Phone
Annual gross salary $
Other (comm/bonus) $
Other income
Amount $
Former employer
Occupation
Address
Street Address
City
State
Zip Code
Dates of employment
Supervisor
Phone
BANK INFORMATION
Bank (checking account)
Branch Address
Account No.
Bank (savings account)
Branch Address
Account No.
Bank (certificate of deposit)
Branch Address
C.D. Account No.
650 McChord St
Colorado Springs, CO 80916
719.597.7200 tel
719.380.8956fax
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