RENTAL/PURCHASE APPLICATION
“This is a legally binding contract. If not understood, seek competent legal advice.”
$____25.00______CASH NON REFUNDABLE APPLICATION FEE
PROPERTY APPLIED FOR 1216 West 6th St EXPECTED MOVE-IN DATE_____10/01/2011_____
MONTHLY RENT ______$775.00______TERM: ______1 Year or ______2Years
SECURITY DEPOSIT ____$700.00______+ NON REFUNDABLE PET DEPOSIT _____$250.00______
TENANT/PURCHASER NAME LAST: ______FIRST: ______MI: ______
SS#: ______-______-______BIRTHDAY: ______
HOME PHONE NUMBER: ______CELL PHONE NUMBER: ______
EMAIL ADDRESS: ______BEST TIME TO CALL: ___AM______PM______Anytime______
NEAREST RELATIVE NOT LIVING WITH YOU: ______PHONE: ______
EMERGENCY CONTACT NAME ______PHONE: ______
CURRENT RESIDENCE:
STREET NAME: ______CITY: ______STATE: ______ZIP: ______
APARTMENT #: ______LANDLORD: ______PHONE: ______
HOW LONG HAVE YOU LIVED THERE: ______MOTHLY PAYMENT: ______
REASON FOR LEAVING: ______
PREVIOUS RESIDENCE:
STREET NAME: ______CITY: ______STATE: ______ZIP: ______
APARTMENT #: ______LANDLORD: ______PHONE: ______
HOW LONG HAVE YOU LIVED THERE: ______MOTHLY PAYMENT: ______
REASON FOR LEAVING: ______
ADDRESS ON DRIVER LICENSE: ______
DRIVERS LICENCE NUMBER: ______STATE ISSUED: ______
TYPE CAR: ______YEAR: ______TAG#: ______STATE:______
OCCUPATION: ______EMPLOYER: ______HOW LONG: ______
EMPLOYER PHONE NUMBER: ______CONTACT PERSON: ______
MONTHLY INCOME: ______OTHER INCOME: ______SOURCE: ______
PREVIOUS EMPLOYER (IF LESS THAN TWO YEARS) ______
EMPLOYER PHONE NUMBER: ______CONTACT PERSON: ______
HOW LONG: ______MONTHLY INCOME: ______
MONTHLY LIABILITIES: RENT: ______AUTO: ______UTILITIES: ______
PHONE: ______CREDIT CARDS: ______INSURANCE: ______CHILD SUPPORT: ______
ALIMONY: ______LOANS: ______OTHER: ______
Do you own any Real Estate now? ______Yes ______No (if yes, list address at bottom or on back)
Have you ever been evicted from tenancy? ______Yes ______No
If Yea, please explain: ______
Do you have any credit problems? ______
What is your present credit rating? Excellent ______Good ______Fair ______Poor ______Unsure ______
Have you had a Bankruptcy in the last 7 years: Yes______No______If yes, year dismissed: ______
If yes, explain: ______
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IF I/WE ARE ACCEPTED THE FOLLOWING PERSONS WILL BE LIVING WITH ME/US:
NAME RELATIONSHIP
1) ______
2) ______
3) ______
DESCRIPTION OF PETS:
______
I HEREBY CERTIFY THAT THE ANSWERS THAT I HAVE GIVEN IN THIS APPLICATION ARE TRUE AND TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT FALSE ANSWERS OR STATEMENTS MADE BY ME WILL BE SUFFICIENT GROUNDS FOR EVICTION/FORECLOSURE AND LOSS OF ALL MONIES PAID. FURTHERMORE IF FOR ANY REASON I BECOME DELINQUENT IN MY RENT I AUTHORIZE YOU TO USE MY MASTERCARD, VISA OR OTHER CREDIT CARD LISTED ABOVE OR THAT I MAY OBTAIN. I AUTHORIZE YOU TO EXAMINE ANY INFORMATION LOCATED ON MY CREDIT AND CRIMINAL RECORDS.
APPLICANT SIGNATURE x______DATE ______
When completed, please return to:
Beachside Tide, LLC
174 East Coast Drive
Atlantic Beach, FL 32233
Our contact information is:
Carl Edwards (904) 234-4975
CREDIT REPORT AUTHORIZATION AND RELEASE
Authorization is hereby granted to the Seller, and/or Beachside Tide, LLC hereafter referred to as (Company), any of its agents, affiliates, or referred lenders, to obtain a standard factual data credit report through a credit reporting agency chosen by Company.
My signature below authorizes the release to the credit-reporting agency a copy of my credit application, and authorizes the credit-reporting agency to obtain information regarding my employment, savings accounts, and outstanding credit accounts (mortgages, auto loans, personal loans, charge cards, credit unions, etc). Authorization is further granted to the reporting agency to use a photo static reproduction of this authorization if necessary to obtain any information regarding the above-mentioned information.
The undersigned applicant hereby authorizes Landlord, Leasing Agent, Seller, Company, any of its agents, affiliates and/or referred lenders to contact them directly to discuss any of the matters as may be necessary in the course of obtaining information to facilitate the purchase of a property.
The undersigned applicant hereby authorizes the Landlord, Leasing Agent, Seller, Company, any of its agents, affiliates and/or referred lenders to contact me directly to discuss any possible questions that they might have.
Any reproduction of this Credit Report Authorization and Release made by reliable means (for example, photocopy, scanned e-mail or facsimile) is considered an original.
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Buyer(s) Printed Full Name Co-Buyer(s) Printed Full Name
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Buyer(s) Signature Date Co-Buyer(s) Signature Date
NO PERSON OR PERSONS SHALL BE DENIED THE RIGHT TO RENT OR PURCHASE OUR PROPERTY BECAUSE OF THEIR RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN OR ANCESTRY.
All information contained herein is strictly confidential, and is for the sole purpose of determining how our program would best be suited for your present financial needs and future goals.