Rental/credit Application Form Page 2
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3PERSONAL REFERENCES
NAME
RELATIONSHIP
TELEPHONE
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
CREDIT REFERENCES
CREDIT GRANTOR
ADDRESS
TELEPHONE
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
_______________________________________ ___________________________________ ___________________________
OTHER INFORMATION
PERSONAL / CREDIT REFERENCES
Number of vehicles (including company cars)___________________________________________________________________
Make/Model________________________________ Year_______ Color __________ Tag No. ________________ State ______
Make/Model________________________________ Year_______ Color __________ Tag No. ________________ State ______
Make/Model________________________________ Year_______ Color __________ Tag No. ________________ State ______
HAVE YOU EVER:
Filed for bankruptcy?
No
Yes
If yes, when?______________________________________________________
Been served an eviction notice or been asked to vacate a property you were renting?
No
Yes
If yes,
when?______________________________ why?____________________________________________________
Willfully or intentionally refused to pay rent when due?
No
Yes
If yes, when? ________________________
why? _______________________________________________________________________________________
How were you referred to us?
Newspaper (name) ____________________________
Realtor (name) __________________
Other ___________________
Friend (name)_____________________________
Sign (location)__________________
Rental Unit applied for_____________________________________________________________________________________
Commencement date __________________________ Term _____________________ Rent/Month _______________________
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