North Carolina Rental Application Page 3

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References  
Name:      
Phone:  
 
 
Name:      
Phone:  
 
 
Pets   ( #,   K ind,   B reed,   W eight   &   A ge)  
 
 
Alimony   y ou   r eceive   $    
Child   S upport   y ou   r eceive  
$    
 
Have   y ou   e ver   b een   e victed?   Y es               N o               F iled   f or   B ankruptcy?   Y es               N o              
How   d id   y ou   h ear   a bout   u s?  
 
Instructions   f or   T his   O ffer   t o   b e   C onsidered   b y   L andlord  
Please  read  carefully!  
This   a pplication   h ereby   c onstitutes   m y   o ffer   t o   t he   o wner   o f   t he   a bove-­‐described   p remises   ( hereinafter   " premises");  
through   t he   o wner's   a gent,   _ ____________________________   t o   l ease   t he   p remises   f or   t he   t erm   a nd   c onditions   s et  
forth   i n   t his   o ffer.   I ncluded   w ith   t his   o ffer   i s   t he   n on-­‐refundable   a pplication   f ee   o f   $ _____   d ollars   f or   e ach   i ndividual   o r  
married   c ouple   m ade   p ayable   t o   _ ______________________   a nd   p aid   a t   t he   t ime   t his   o ffer   i s   s ubmitted.   S hould   t his  
offer   b e   s ubmitted   b y   f ax   o r   e mail,   d eliver   t his   f ee   t o:  
 
________________
________________
________________
________________  
 
Your   o ffer   w ill   n ot   b e   p rocessed   u nless   t he   p aperwork   i s   f illed   o ut   c ompletely   a nd   a pplication   f ee   i s   r eceived.  
 
I   h ereby   a uthorize   _ ____________________   a nd/or   o wner,   t o   w hom   t his   o ffer   i s   m ade,   a nd   c redit   b ureau   o r   o ther  
investigative   a gency   e mployed   b y   _ _______________,   t o   i nvestigate   t he   r eference   h erein   l isted,   s tatements,   o r   o ther  
data   o btained   f rom   m e   o r   f rom   a ny   o ther   p erson   p ertaining   t o   m y   c redit,   f inancial   r esponsibility   a nd   q ualifications   a s  
a   l essee.   I   h ereby   r elease   a ll   p arties   f rom   a ll   l iability   f or   a ny   d amage   t hat   m ay   r esult   f rom   f urnishing   t his   i nformation  
to   _ ____________________.   I   h ereby   a cknowledge   t hat   t he   a bove   i nformation   i s   c orrect   t o   t he   b est   o f   m y  
knowledge.  
 
I   u nderstand   t hat   i n   t he   p rocess   o f   v erifying   i nformation   o n   m y   r ental   a pplication,  
____________________________   a nd/or   o wner   m ay   b e   c ontacting   m y   c urrent   l andlord   o r   m ortgage   h older   f or  
verification   p urposes.  
 
Once   y our   a pplication   i nformation   i s   p rocessed,   w e   w ill   c ontact   t he   o wner   o f   t he   p roperty   t o   p resent   y our   r ental   o ffer.  
The   o wner   i s   a uthorized   t o   r eceive   c opies   o f   t he   i nformation.   P lease   a llow   s ufficient   t ime   ( usually   2   b usiness   d ays)   f or  
the   o wner   t o   a ddress   y our   a pplication.   I f   y our   a pplication   i s   d enied,   w e   w ill   n otify   y ou.   U pon   a pproval   o f   y our  
application,   a   l ease   w ill   b e   d rafted   a nd   a rrangements   f or   o btaining   s ignatures   w ill   b e   m ade.  
 
The   p roperty   i s   a vailable   f or   t he   a dvertised   l ease   t erm.   I f   y ou   r equest   a   l ease   t erm   o ther   t han   t hat   a dvertised,   t he  
landlord   m ay   r equest   a dditional   r ent   o r   m ay   d eny   y our   a pplication.  
 
Please   n ote   t hat   i f   y ou   d o   n ot   m ake   y our   r equest   i n   t he   s pace   i ndicated   b elow   t hat   y ou   m ust   r equest   a dditional  
items   i n   w riting   f rom   t he   o wner   o r   h is/her   a gent,   a nd   s uch   i tems   m ay   p ossibly   b e   d enied.  

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