RENTAL APPLICATION - 9425 State Line

Neatly complete all information below.  All applicants over the age of 18 must complete and sign their own application.

Applicants full name___________________________________Phone #________________DOB______________

Social Security #______________________Drivers License #___________________State_______Exp._________

Current Address________________________________City___________________State_______Zip_________

How long at this address_____________Reason for leaving_____________________________________________

Previous Address_______________________________City___________________State________Zip__________

How long at this address___________Reason for leaving_____________________________________________

Auto Yr________Make_______________Model___________________State/License Plate #__________________

Present Employer_____________________________Position___________________Mo. Income______________

Phone #__________________How long at job_____________Other income/source__________________________

Employers Address______________________________________City____________________State___________

Co-Applicants full Name_______________________________Phone#___________________DOB____________

Social Security #____________________Drivers License #_____________________State_______Exp._________

Auto Yr_______Make________________Model__________________License Plate #/State__________________

Present Employer____________________________Position___________________Mo. Income_______________

 Employers Address_______________________________________City/State_______________________________

 Phone#__________________How long at this job________________Other income.source____________________

 Number and type of Pets____________________Have either of you ever been party to an eviction?  [ ] Yes  [ ] No

 Smoker: [ ] Yes  [ ] No                 Waterbed:  [ ] Yes  [] No 

Desired date of occupancy: _____________________    Desired length of occupancy: _______________________

 Personal References

Name__________________________Yrs. Known_____Relationship__________________Phone #_____________

 Name__________________________Yrs. Known_____Relationship__________________Phone #_____________

 Name__________________________Yrs. Known_____Relationship__________________Phone #_____________

 Total number of adults____________Total number of children living with you under the age of 18,even if on a temporary basis ______________

 Names and relations of all other applicants__________________________________________________________

 ____________________________________________________________________________________________

  

I CERTIFY that answers given herein are true and complete to the best of my knowledge.  I authorize investigation of all statements contained in this application for tenant screening as may be necessary in arriving at a tenant decision, I understand that the landlord may terminate any rental agreement entered into for any misrepresentation made above.  A credit report fee of $25.00 is due with this application.

You must include a copy of your latest paycheck stub with the application!

Applicant_______________________________________________________Date_______________________

Co-applicant_____________________________________________________Date_______________________

 

Received from applicant (s) the non-refundable sum of $______ dollars to pay for a credit check to verify the Applicant’s credit references and credit history in connection with the processing of the Rental Application.

APPLICANT DISCLOSURE FORM

         APPLICANT COMPLETE AND SIGN !

Applicants Name_______________________________________________

 Address____________________________________________________

 City/State/Zip________________________________________________

 Social Security Number_____________________________________

Date of Birth___________
Drivers License #/State_____________________

I authorize PHIL and PAT LYON to obtain my consumer credit report and public records and to investigate any personal information on me necessary to arrive at an applicant decision.

 

Signature_______________________________Date____/____/_____

After completing, please fax to 662-895-3112 or call 662-895-3116 if you do not have access to a fax machine.

 


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