BACKGROUND INFORMATION
HAVE YOU EVER:
Filed for bankruptcy?
Willfully or intentionally refused to pay rent when due?
Been evicted from a tenancy or left owing money? If yes, please provide Property Name, City, State, and Landlord Name.
Yes
No
Do you smoke?
Been convicted of a crime? If yes, please provide Type of Offense, County, and State.
Yes
No
Yes
No
VEHICLE INFORMATION
1. MAKE & MODEL
YEAR
LICENSE NO. & STATE
2. MAKE & MODEL
YEAR
LICENSE NO. & STATE
OTHER VEHICLES
OTHER INFORMATION
HOW DID YOU HEAR ABOUT THIS PROPERTY?
PLEASE INCLUDE ANY OTHER INFORMATION YOU BELIEVE WOULD HELP TO EVALUATE THIS APPLICATION
I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the
rental is to be payable the 1st day of each month in advance. I warrant that all statements above set forth are true.
I hereby give my permission to communicate with my current and former landlord or property manager for the purpose of
discussing any and all of the facts and circumstances of my current or former tenancy, as well as the other information listed
above. I also give my permission to communicate with my current employer(s) and/or supervisor(s) for the purpose of
verifying the employment information listed above. I understand there are no limitations or restrictions regarding what may be
discussed or revealed. I am aware that a credit history, eviction search and criminal background check will be done in
conjunction with my application. I understand that I may have the right to make a written request within a reasonable period
of time to receive additional, detailed information about the nature and scope of this investigation.
(Signed/Applicant)
Date