Rental Application s1

Rental Application

Instructions: If you are serious about renting a property from Elizabeth Carper Real Estate, Please, complete ALL sections listed on the front & back of this application.

Personal Information:

Applicant’s Full Name ______Date of Birth ______

Social Security # ______Age ______Driver’s License # ______

Cell Phone ______Home Phone ______Work Phone______

Marital Status: Married Single Divorced Separated Widowed

Employment:

Employer ______Employer#______Position ______

Length of Employment ______Address of Employment ______

Monthly Income ______Yearly Income ______Household Income ______

Automobile:

Make of Car ______Year______Color ______License Plate# ______State ______

Residential History: Please give history for past two years

Present Address ______Length of Residency______

Monthly Rent ______Reason for Moving ______

Landlord Name ______Landlord Phone# ______

Please circle & fill out the following questions:

1. Anyone else live at this residence? Yes Or No

If yes, please print name & phone# ______

2. Were you evicted from this property? Yes Or No

If yes, please print reason for this action ______

3. Did you leave balance at this property? Yes Or No

If yes, please print how much & reason balance was left ______

Residential History continued…

Previous Address ______Length of Residency______

Monthly Rent ______Reason for Moving ______

Landlord Name ______Landlord Phone# ______

Please circle & fill out the following questions:

1. Anyone else live at this residence? Yes Or No

If yes, please print name & phone# ______

2. Were you evicted from this property? Yes Or No

If yes, please print reason for this action ______

3. Did you leave balance at this property? Yes Or No

If yes, please print how much & reason balance was left ______

References: (No Family Members)

Name ______Phone#______Relationship______

Please List 2 close family Members:

1. Name ______Phone#______Relationship______

Address ______

2. Name ______Phone#______Relationship______

Address ______

Emergency Contact:

Name ______Phone#______

Address ______Relationship______

I certify that the above information is correct, & I understand that this application may be revoked if any information furnished upon this application is found to be incorrect.

I authorize you to contact any references listed on this application and obtain a credit report as well as a police background check.

WE DO NOT ALLOW DRUGS, DRUNKS, OR ANY ILLEGAL ACTIVITY.

______

Applicant’s Signature Date