PINNACLE ESTATES OF GLENDIVE LLC
DBA PINNACLE ESTATES & EXTENDED STAY RV
EIN 82-3116213
31 HWAY 16 GLENDIVE, MT 59330
APPLICATION FOR MOBILE HOME LOT & EXTENDED STAY RV RENTAL
Date of this Application:______
Please indicate Mobile Home or Extended Stay RV Lot:______
Desired dates of occupancy:______
Do you have pets? If YES, complete Pet Profile.
PERSONAL INFORMATION
Applicant's full name:______
Date of Birth:______
Social Security #:______
E-Mail address of applicant (required):______
Have you been known by any other names? If so, please indicate:______
Name, E-mail address, Dates of Birth and Social Security # of all applicants 18 years of age and older other than the above applicant who will be residing in the unit:
______
______
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Have you or any member of your household ever been convicted of or pleaded guilty or "no contest” to a felony? Yes______No______
Have you or any member of your household ever been convicted of or pleaded guilty or “no contest” to a misdemeanor involving sexual misconduct? Yes______No______
If yes, please describe:______
Are you required to register as a sexual or violent offender? Yes______No______
RESIDENCE HISTORY We require two (2) rental references or two (2) full years of rental history, whichever is greater. Please list your actual landlord or property manager, NOT ROOMMATES.
Present Address:______
How long there? From ______To ______Amount of Rent:______
Present Landlord: ______Phone/ Cell: ______
Reason for Leaving: ______
Present Address:______
How long there? From ______To ______Amount of Rent:______
Present Landlord: ______Phone/ Cell: ______
Reason for Leaving: ______
PERSONAL REFERENCES (No relatives):
INCLUDE NAME…ADDRESS….PHONE#
1)______
2)______
3)______
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The statements on page 1 and 2 are true and correct.
I hereby verify that I am 18 years or older, or otherwise competent to enter into a binding rental contract and I will be fully responsible for the terms of the rental contract. I hereby authorize the landlord, his agent or staff to contact any persons, corporations, employers, agencies, offices, groups or organizations to obtain any information, credit report or material which is deemed necessary to verify the information and statements in the application are true. In the event the application is approved, and I desire to lease the mobile home lot, I agree to fill out and sign the lease agreement (does not apply to Extended Stay RV). I also acknowledge that as part of the application process I and all proposed Tenants age 18 and over will be contacted by email by SmartMove to complete an online screening at a charge of $35 per applicant “non-refundable” to determine whether my application will be approved or declined. All proposed Tenants age 18 and older please sign.
SIGNATURE: ______Date:______
SIGNATURE:______Date:______
SIGNATURE:______Date:______
SIGNATURE:______Date:______
AFTER YOU HAVE COMPLETED YOUR APPLICATION PLEASE E- MAIL TO:
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