TENANT APPLICATION
Personal Information and Financial Statement
(Please fill out completely)
Property Address: ______Unit #: ______
PERSONAL INFORMATION
Name of Applicant: Last:First: Middle:
Home Address:
Previous Address (of less than 2 years):
Date of Birth:
Drivers Lic. #: State:Social Security #:
Home Telephone #: Business Telephone #:
Cellular Telephone #: Email:
Employer:Telephone #:
Employer Address:
Occupation:Monthly Income:
HAVE YOU EVER FILED FOR BANKRUPTCY?
Business: Yes No When:State Filed:Chpt:
Personal: Yes No When:State Filed:Chpt:
HAVE YOU EVEN BEEN CONVICTED OF A FELONY? Is so, when:
What felony:
MORTGAGE HOLDER:
Personal:Acct#:Tel#:
Address:Contact:
MORTGAGE HOLDER:
Business:Acct#:Tel#:
Address:Contact:
BUSINESS INFORMATION
Full Legal Company Name: Lease Term (Yrs.):
DBA:
Business License #: Federal Employ. ID #:
Date Fictitious Bus. Name filed:
Business Address:
Description of Business:
Years in this Location: # of Stores: Where:
Regarding your planned business: Please complete the following and attach additional information regarding your related background and business plans as necessary.
What are your planned hours of operation for the business? / How many employees do you anticipate?Monday / to: / Total: / At any one time:
Tuesday / to:
Wednesday / to: / Who will manage the business on a day-to-day basis?
Thursday / to:
Friday / to:
Saturday / to:
Sunday / to:
What background do you have in this business? (Please attach a resume as necessary).
______
______
How do you plan to generate business?
______
______
How much do you estimate you will spend fixturizing the premises? $
How much do you estimate you will spend on inventory? $
How do you plan to finance these costs (savings, loans, etc)? $
PLEASE LIST ALL BANK(S): (Business & Personal)
Name of Bank:Branch:Tel #:
Address:
Account Name: Acct. #:Personal: Business:
Name of Bank:Branch:Tel #:
Address:
Account Name: Acct. #:Personal: Business:
PLEASE LIST ALL CREDIT REFERENCE (S): (Business & Personal)
Name: Tel #:
Address:
Account Name: Acct. #:Personal: Business:
Name: Tel #:
Address:
Account Name: Acct. #:Personal: Business:
TRADE REFERENCES, BUSINESS (if none, Personal)
Current Landlord’s Name:Tel. #:
Address: How long as tenant:
Insurance Agency: Tel. #:
Address: Agent:
INFORMATION CONCERNING EXISTING LOCATION:
What is the size of the facility / office that this new space will replace?
What is the monthly rent for the space that is being replaced? $
What is the reason for acquiring the new space?
IN CASE OF EMERGENCY PLEASE CONTACT:
Name: Tel. #:
Address:
Name: Tel. #:
Address:
The information contained in this Person Information ad Financial Statement is certified as true and accurate as of the date executed and the date delivered by the undersigned and you are authorized to conduct a credit and background check. It is understood that you intent to materially rely on this information if you enter into any lease, guarantee of lease, transfer of lease, or other agreement with this undersigned. Any attachment or additional pages are a part of here of.
By Lessee:
Executed at:
On:
Applicant Signature
Name Printed:
Title:
Co-Applicant Signature
Name Printed:
Title:
Co-Applicant Signature
Name Printed:
Title:
Date: 201
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