Premises and Lease Information:
Address: ______________________________
Description: ______________________________
Parking: ______________________________
Rental Start Date: _______________ Lease Term: _______________
Monthly Rent: $_______________ Security Deposit: $_______________
Application Fee: $_______________ # of Occupants: _______________
Applicant Information:
Name: ______________________________
Current Address: ______________________________
Home Tel. Number: _______________ Work Tel. Number: _______________
Driver's License No.: _______________ Social Security No.: _______________
Driver's License No.: _______________ Social Security No.: _______________
Applicant's Employment History:
Occupation: _______________
Employer's Name: ______________________________
Employer Tel. Number: _______________ Length at this Job: _______________
Employer Contact Person: ______________________________
Current Salary: $_______________
Applicant's Financial History:
Checking Account #: _______________ Savings Account #: _______________
Bank Name: ______________________________
Bank Address: ______________________________
Credit Reference: __________________ Tel. Number: _______________
Have you ever been evicted? _____
Have you ever been sued for unlawful detainer? _____
Have you ever been delinquent in paying rent during the last 3 years? _____
Name of Last Landlord: __________________ Tel. Number: _______________

As a material inducement to be considered as a tenant for the Premises, I herewith consent to and authorize _______________________, or any agent of same, to contact all references named in this application, and to conduct a credit review, including obtaining my credit report from any authorized credit reporting agency or obtain income tax information from the US or State Governments.

I declare under penalty of perjury that the information listed in this application is true and correct.

Executed on this _____ day of _______________, , in the city of _______________, state of _______________.

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