Residental history
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Full Name:
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Date of birth: / /
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SSN: / /
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Phone: ( )
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Work Phone: ( )
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Cell Phone: ( )
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Reason for moving:
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1. Current address:
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Landlord/Mtg. Co. Name:
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City, state & zip:
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From/To Date:
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Landlord/Mtg. Co. daytime phone:
( )
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Landlord evening phone:
( )
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Landlord Cell phone: ( )
Landlord Fax: ( )
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City:
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State:
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ZIP Code:
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Own Rent (Please circle)
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Monthly mtg./rent pymt:
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How long?
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2. Previous address:
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Landlord/Mtg. Co. Name:
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City, state & zip:
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From/To Date:
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Landlord/Mtg. Co. daytime phone:
( )
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Landlord evening phone:
( )
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Landlord Cell phone: ( )
Landlord Fax: ( )
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City:
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State:
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ZIP Code:
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Owned Rented (Please circle)
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Monthly mtg. /rent pymt:
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How long?
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3. Previous address:
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Landlord/Mtg. Co. Name:
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City, state & zip:
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From/To Date:
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Landlord/Mtg. Co. daytime phone:
( )
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Landlord evening phone:
( )
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Landlord Cell phone: ( )
Landlord Fax: ( )
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City:
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State:
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Zip Code:
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Owned Rented (Please circle
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Monthly mtg./rent pymt:
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How long?
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Employment Information
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Current employer or source of income:
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Employer address:
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How long?
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Supervisor Name:
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Title:
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Phone:
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E-mail:
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Fax:
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City:
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State:
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ZIP Code:
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Position:
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Hourly Salary (Please circle)
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Annual income:
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Previous employer:
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Supervisor Name:
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Title:
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Address:
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How long?
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Phone:
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E-mail:
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Fax:
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City:
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State:
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ZIP Code:
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Position:
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Hourly Salary (Please circle)
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Annual income:
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Other Sources of Income:
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Gross Monthly Income:
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Documentation is required to verify other income:
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OTHER INFORMATION
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Name of a relative not residing with you:
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Address:
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Phone: ( ) Work: ( )
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City:
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State:
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ZIP Code:
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Relationship:
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Vehicle make, Model, Year: Tag # State:
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List other occupants names & ages:
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Do you have a legal right to be in the United States? [ ]Yes, I am a U. S. Citizen [ ]Yes, I have a valid documentation from the Bureau of Citizenship and Immigration Service [ ] No
If you answered YES" because you are a non-U.S. citizen with valid visa documentation, please provide:
Reason you are in the U.S.______________________________Visa Type_______________________________Visa Exp. Date:
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Have you ever filed bankruptcy [ ]No [ ]Yes Date: Has Bankruptcy been Discharged/Dismissed? [ ]Yes [ ]No
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CONTINGENCIES OF THIS LEASE
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Pets (list number, breed, age & weight):
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PLEASE READ AND SIGN APPLICATION
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NON-REFUNDABLE CREDIT CHECK AND PROCESSING CHARGE
Applicant submits herewith a non-refundable payment in the amount of $_________for credit check and processing charge. If application is not approved said sum will be retained by Management to cover the costs of processing this application. Any false information will constitute grounds for rejection of application. Management is hereby expressly authorized to verify the accuracy and correctness of the statements contained herein, to communicate with applicant's employers and creditors, and to procure such other information, which Management may require to evaluate this application.
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DISCLOSURE
I, undersigned, understand that American Realty & Property Management, is the Agent and representative for the owner and will be paid a fee by the owner. I also understand that this property is being leased "AS IS" in its present condition. Any stipulations, changes or modifications, which I require of the property, or the lease term, are written on the back of this application and signed by me. If any stipulations cannot be met, or an acceptable compromise agreed to by all parties, I understand that my pre-paid rent fee will be returned to me.
(Initial here if stipulations are listed on the back)______________
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FOR OFFICE USE ONLY BELOW THIS LINE
(To Be Completed By American Realty & Property Management)
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