Rental Application Form Page 3
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3The undersigned warrants and represents that all statements are true and agrees to execute upon presentation a lease in
usual form, a copy of which the applicant has had occasion to examine, which lease may be terminated by the Lessor if
any statements herein made are incomplete or not true.
The undersigned authorizes management to contact any references listed, including past and present landlords and
employers and obtain a current credit check and criminal background check.
All persons will be treated fairly and equally without regard to Race, Color, Religion, Sex, Handicap, Familiar Status or
National Origin in compliance with the Fair Housing Act.
___________________________
1. __________________________________________
Date
Signature of Applicant
__________________________________________
Printed Name of Applicant
___________________________
2. __________________________________________
Date
Signature of Applicant
_________________________________________
Printed Name of Applicant
___________________________
3. __________________________________________
Date
Signature of Applicant (if applicable)
_________________________________________
Printed Name of Applicant
___________________________
__________________________________________
Date
Signature of Owner/Agent
My HomeTown Properties, LLC▪P.O. Box 575752▪Salt Lake City, UT ▪84157
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