SS and DOB (enter numbers only)*
Current Home Address With Dates*
Previous (2) Home Addresses With Dates(Include all or type none)*
Last Three Employers, Dates Of Employment Plus Monthly Income For Each (Include all with supervisor name and phone number)*
Proposed (minor) Occupants (Include all or type none)*
Proposed Pet (s) (Include all or type none)*
Vehicle Information With Year, Make and Model (include all or type none)*
List Each Creditor By Name With Total Balance Due (Include monthly payment amount for each) ie. credit accounts, car loans, etc*
Three Emergency/Personal References (Include names, addresses and phone numbers)*
Has Applicant Ever Been Sued For Bills*
Has Applicant Ever Been Locked Out Of Their Apartment By The Sheriff*
Has Applicant Ever Had Court Relief for Past Due Bills*
Has Applicant Ever Been Brought To Court By Another Landlord*
Has Applicant Ever Been Guilty Of A Felony*
Has Applicant Ever Moved Owing Rent Or Damaged An Apartment*
Has Applicant Ever Broken A Lease*
Is The Total Move-In Amount Available Now (Rent and deposit)*
Applicant authorizes the landlord to contact past and present landlords, employers, credit bureaus, neighbors and any other sources deemed necessary to investigate applicant. All information is true and accurate and complete to the best of the applicant's knowledge. Landlord reserves the right to disqualify tenant if information is not as represented. ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FORM AT ANY TIME.*
The entering of the applicant's full name on this line indciates the applicants signature (Please include date)*
