Application for Barron Mobile Home Parks
Application for Lot Rental to: Lot # ______687 S. Mill Street (Mill Street Acres)
Lot # ______1469 E. Division Avenue (East End Estates)
Lot # ______300 E. Taylor Avenue (Riverview Terrace)
Hillside Homes of Barron Inc. Gloria & Mark O. Dobberfuhl, Owners
Manufactured Home Communities 1371 U.S. Highway 8
687 E. Mill St. or 1469 E. Division Ave. Barron, WI 54812
Barron, WI 54812 (715)637-5579
Riverview Terrace, Inc.
Manufactured Home Community
300 E. Taylor Avenue
Barron, WI 54812
PLEASE PRINT:
Applicant's Full Name: ______
Date of Birth: ______Social Security No.: ______
Your present address: ______
How long at present address: ______
Previous address in last two years: ______
Phone No. ______Driver's License No.______
E Mail ______
Spouse or other adult: ______
Date of birth: ______Social Security No.: ______
Driver's License No.: ______Phone: ______
Names and Ages of Children: ______
Your employer: ______
Address of employer: ______
Your occupation: ______
Spouse’s or other adult’s employer: ______
Address of employer: ______
Occupation: ______
Your Bank: ______
Give name, address and phone for two references:
1. For Credit: ______
2. As a tenant: ______
Give name of prior landlord: ______
Address: ______Phone: ______
Do you have a mobile home now? _____Yes _____No
Size: ______Year Built: ______Make: ______
Approx. Value: $______Serial #:______Model: ______
Any special circumstances (infants, elderly, life sustaining equip)? ______
______
Date: ______Signed: ______
Signed: ______
Release of Financial, Employment or Other Records
To: ______
______
______
At my request would you please supply to Gloria or Mark O. Dobberfuhl, 1371 U.S. Highway 8, Barron, WI 54812, with whatever information you have relating to:
______My financial records and other financial information.
______My employment and all related records.
______My tenancy and all related records.
______Other: ______
______
Authorization is further granted to Gloria or Mark O. Dobberfuhl to use a photocopy of my signature below to obtain information regarding any of the aforementioned items.
I agree to hold you harmless by reason of furnishing such information.
Dated this _____day of ______, 20___
Signed: ______
Print Name: ______
REQUEST FOR A CREDIT REPORT
Obtain a credit report by logging on to the following website:
www.annualcreditreport.com
Return it to Dobberfuhls for review. It will be returned to you.
You can log onto the website once a year and obtain a free report.