Property Address______________________________________________________

Full Name_________________________Phone Number____________Age_____ Social Security____________________Driver’s Lic. #______________________

Present Address__________________________How Long:__________________ PresentLandlord_________________________Phone#:________________ PreviousAddress:_______________________HowLong:_______________

Previous Landlord:___________________________Phone#____________________

Employer’s(name,address)_____________________________________________________________________________________________________

Phone #:_________________________________

Job Title:___________________Yrs.Employed____Mo.Income_________

Previous Employer(address/phone)_________________________________________

Automobile(s):

Year:______Model____________________________License #:___________________

Year:______Model____________________________License #:___________________

Bank and Account #:______________________________Branch__________________

Person to be notified in case of emergency:

Name:___________________________Address:____________________

Phone:______________

Why are you moving?_____________________________________________________

Have you ever been evicted? Yes_______ No_________

If yes, explain:__________________________________________________

Have you ever been convicted of a felony? Yes_______ No_________

If yes, explain:______________________________________________

By signing below I give consent to a full credit check:

Applicant’s signature:__________________________________________

Amount of deposit:__________________ Date_____________________