HILLTOP
HOLDINGS LLC
5501 Queensgate Drive
Knoxville, Tennessee 37918
865-922-8657
MAILTO:

RENTAL APPLICATION

Falsely reporting, or intentional misrepresentation of any information herein, will result in forfeit of deposit monies being held by Hilltop Holding resulting in the lease being terminated immediately, and may be punishable by law.

THIS SECTION TO BE COMPLETED BY LANDLORD

Click

Address of Property to be leased: Sulpher Creek Road, Helenwood, TN 37755

Rental Term: 1 YEAR LEASE / From: / Click date / To: / Click date
First Month’s Rent: …………………………………….* / $ Click enter
Security Deposit: ……………………………………….* / $ Click enter
Background Check Fee: ……………………………… / $ Click enter
Non Refundable Pet Deposit: ……………………… / $ NO PETS
Other (specify): ………………………………………… / $ Click enter
TOTAL Due Prior to Occupancy: / $ Click enter

Monthly Rent Payment = $ Monthly Rent Due on Day of Month day of each month.

Unit contains the following property/appliances that are being furnished by owner.

*Tenant responsibility for first $50.00 repair

Range / Refrigerator - YES / Washer / Dryer – YES
Microwave Oven - Click here to enter text. / Dishwasher – Click here to enter text.

*See terms in lease agreement.

HILLTOP

HOLDINGS LLC

Section to be completed by Applicant

Falsely reporting, or intentional misrepresentation of any information herein, will result in forfeit of deposit monies being held by Hilltop Holding resulting in the lease being terminated immediately, and may be punishable by law.

Applicant 1 Applicant 2

Full Name(s): / Click here to enter text. / Click here to enter text.
Home Phone(s): / Click here to enter text. / Click here to enter text.
Cell Phone(s): / Click here to enter text. / Click here to enter text.
Social Security No.: / Click here to enter text. / Click here to enter text.
Driver’s License Number/State: / Click here to enter text. / Click here to enter text.
Birth Date: / Click here to enter text. / Click here to enter text.

Vehicle(s)

Vehicle / Make: / Model: / Color: / Year: / License Plate Number: / State:
1 / Click / Click / Click / Y / # / NN
2 / Click / Click / Click / Y / # / NN

Additional Occupants

List everyone, including children, who will live with you:

Full Name Relationship to Applicant and age.

Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.

HILLTOP

HOLDINGS LLC

Rental History

Current Address: / House, Street, City, State
Dates Lived at Address: / MM/YY – MM/YY
Reason for Leaving: / Click here to enter text.
Landlord/Manager: / Name: First & Last / Phone # NNN-NNN-NNNN

Employment History

Applicant 1 Applicant 2

Name of current Employer: / Click here to enter text. / Click here to enter text.
Net Monthly Income / $ Click enter / $ Click enter
Work Phone: / NNN-NNN-NNNN / NNN-NNN-NNNN
Name of Supervisor: / Click here to enter text. / Click here to enter text.
Dates Employed at this Job: / MM/YY – MM/YY / MM/YY – MM/YY
Supervisor Phone: / NNN-NNN-NNNN / NNN-NNN-NNNN
Name of prior Employer: / Click here to enter text. / Click here to enter text.
Dates Employed at this Job: / MM/YY – MM/YY / MM/YY – MM/YY
Name of prior Supervisor: / Click here to enter text. / Click here to enter text.

Emergency Contacts

Name: / Click here to enter text. / Relationship: / Click here to enter text.
Street: / Click here to enter text. / Home Phone: / Click here to enter text.
City: / Click here to enter text. / Cell Phone: / Click here to enter text.
State: / Click here to enter text. / Work Phone: / Click here to enter text.

Please list 2 Professional and 3 Personal References:

Names / Phone Number
1. Click here to enter text. / Click here to enter text.
2. Click here to enter text. / Click here to enter text.
3. Click here to enter text. / Click here to enter text.
4. Click here to enter text. / Click here to enter text.
5. Click here to enter text. / Click here to enter text.

HILLTOP

HOLDINGS LLC

Applicant Personal History

Have you or anyone that will be on the premises ever been charged or convicted with any of the following:

Please check one.

YES/NO / YES/NO
Anyone smoke: / click / Filed Bankruptcy: / click
Felony charges or convictions: / click / Have you ever been evicted: / click
Currently on probation: / click / Outstanding warrants: / click
Child abuse: / click / Drug possession: / click
Sex offenses: / click / Sale of drug or paraphernalia: / click
Selling of drugs: / click / Other charges or convictions: / click
Registered sex offender: / click / Assault or Domestic Violence: / click

(Any of the above marked ‘Yes” will require more information.)

I certify that all the information given above to be accurate. I understand that my lease/rental agreement may be terminated and my security deposit forfeited if I have made any false or incomplete statements in this application. I authorize Hilltop Holdings in verification of my information provided in this application from background checks, credit bureaus, current and previous landlords, past and current employers, government agencies, and personal references.

Click here to enter text. / Click Date

Applicant Signature(s): Date:

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