Residential Lease Application (Page 2 of 2) in pdf

Residential Lease Application Page 2

NOTIFY IN CASE OF EMERGENCY

NAME

RELATIONSHIP

ADDRESS

CITY/STATE/ZIP

PHONE

NAME

RELATIONSHIP

ADDRESS

CITY/STATE/ZIP

PHONE

VEHICLE INFORMATION

YEAR

MAKE

MODEL

COLOR

PLATE #

PETS

TYPE

BREED

SEX

COLOR

SIZE

OTHER OCCUPANTS

List names and birthdates of all additional occupants 18 years and older:

List names and birthdates of all dependents 18 years or younger:

I warrant that all statements contained in this application are true and accurate and that I have not knowingly

withheld any information which would, if disclosed, affect my application unfavorably. I hereby provide the owner or its

authorized agent with my consent to communicate with my current and former landlords, as well as my current

employer(s) for the purpose of, among other things, verifying the information listed herein. I am aware that a credit

history, eviction search, and criminal background check may be conducted in conjunction with my application.

Any person or firm is authorized to release information pertaining to my credit history or suitability as a tenant upon

presentation of this form or a photocopy of this form.

It is understood that any processing fee associated with this application is non-refundable, but that any security deposit

received from me will be refunded if my application is not approved.

____________________________________________________

_______________________________

Applicant Signature

Date

residential lease application l 2

Residential Lease Application Page 2