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APPLICATION FOR: _______________________________________
APPLICANT’S FULL NAME: _______________________________________
TELEPHONE NO: __________________________
Date of Birth: ________ Soc. Sec. No: _______________ Marital Status: ______ Family Size: ____
Present Address: ________________________________________________________
How Long: ____ Present Landlord or Mortgage Holder: ______________________
Address of Landlord or Mortgage Holder: ___________________________________
Telephone No: ______________
Rent ____ Own ______ House _____ Apt./Townhouse _____ Mobile Home _____
Monthly Payment $___________ Reason for leaving ___________________________
Previous Address: _______________________________________________________
How Long ______ Previous Landlord or Mortgage Holder: ____________________
Telephone No: _________________
Employed By: _____________________________________ How Long ________
Telephone No: __________________
Employer’s Address: ___________________________________________________
Position: _____________________ Salary or Wages: _________Week/Month/Year
CO-APPLICANT’S FULL NAME: ________________________________________
Telephone No: ________________
Date of Birth: ___________ Soc. Sec. No:______________ Marital Status:_______ Family Size: _____
Present Address: ________________________________________________________
How Long: ______ Present Landlord or Mortgage Holder: ____________________
Telephone No: _________________
Rent _____ Own ______ House ____ Apt./Townhouse ______ Mobile Home ______
Monthly Payment $___________ Reason for Leaving __________________________
Previous Address: _______________________________________________________
How Long _____ Previous Landlord or Mortgage Holder ______________________
Telephone No: __________________
Employed By: ______________________________________ How Long ______
Telephone No: ________________
Employer’s Address: _______________________________________________
Position: ___________________ Salary or Wages ____________ Week/Month/Year
Name other Occupants of Home Relationship Birth date
Do you have Pets? Yes ___ No ___ Description ______________________________
Lien holder-Finance Company ______________________________________________
Make of car _________________ Year ______ Color __________ License No: ________ State ______
Make of car _________________ Year ______ Color __________ License No: ________ State ______
Make of car _________________ Year ______ Color __________ License No: ________ State ______
Do you have a R.V./Camper _________ Boat ______ Motorcycle _______
Credit References Acct. No: Telephone or Address
Your Bank ______________Branch____________ Checking_____Savings_______ Acct. No:__________
In Emergency Notify: ____________________________________________________
Address: _______________________________ Telephone: ________________
1. If applicant has misstated the number of persons in applicant’s family or the
Number of persons intended to occupy the home, or if applicant has made any
Misstatement of material facts relating to the application or lease, or if applicant fails to complete the application, Lessor, at its option may cancel the lease without notice.
2. Applicant represents that no real estate broker nor any other person is entitled
To any commission whatsoever from Lessor for this rental.
3. All parties to the lease must execute the lease in the presence of the leasing
Agent.
4. If the applicant and DJH Properties shall enter into a lease, this application
Shall become a part of the lease as though set forth therein.
HAVE YOU EVER BEEN EVICTED OR REQUESTED TO VACATE? YES___ NO____
HAVE YOU EVER BEEN ARRESTED FOR A FELONY? YES _____ NO ______
AMOUNT OF SECURITY DEPOSIT TO BE PAID: $_____________
AMOUNT OF MONTHLY RENT TO BE PAID: $____________
I/We hereby agree, in the event of the approval of this rental application, to execute one year lease in accordance with the terms set forth in the rental application and my/our rental liability shall commence on _________________________ pursuant to the terms of the lease. After the first year lease term, the lease will automatically renew each year without signing a new lease. That if I/We fail to sign lease and/or pay agreed rental, security deposit or other required charges and fees shown in this rental application, the deposit accompanying this rental application shall be forfeited to the Lessor.
I/We understand that if we fail to receive written rejection of this application within 10 days after date hereof, I/We shall be deemed in accordance with this application.
Owner and or agent for owner reserve the right to reject this application within 10 after date hereof and to refuse possession of the above-mentioned accommodation.
I/We have read the foregoing and certify that the information herein submitted by me/us is true and correct, that this rental application is submitted for the purpose of inducing approval of this application in my/our behalf subject to above.
The above concludes this rental application.
I HAVE READ AND UNDERSTOOD THE ABOVE RULES AND REGULATIONS.
_____________________________________ ________________________________
Signature of applicant signature of co-applicant
