There Is a $20 APPLICATION FEE Per Applicant

Matt Brydenthal / Heather Fiser

717 W. Riordan, Flagstaff, AZ, 86001

Office Phone #: (928) 525-9093 Fax #: (928) 233-3866

There is a $35 APPLICATION FEE per applicant (will be refunded if application is not run). The applicant is not required to pay this fee until after he or she has viewed the property. Only checks or money orders are acceptable forms of payment (made payable to REMAX Peak Properties). No cash, credit /debit cards accepted. If you turn in application fees and your application is not run, the application fees become nonrefundable after 30 days. All homes must be viewed prior to running an application.

Address applying for:

Proposed move-in date: / / Proposed move-out date: / /

Applicant # 1 Name:

Applicant’s Phone #: Email Address:

Social Security # (SSN): DOB: / /

Applicant # 2 Name:

Applicant’s Phone #: Email Address:

Social Security # (SSN): DOB: / /

Residence History Current Address:

City State zip

Landlord’s name: Phone #:

From / / To / / Rent $:

Why are you moving?:

Employment (If moving to Flagstaff list employer in Flagstaff)

Applicant #1

Employer: Phone #: Monthly Income (Gross):

Position: Supervisor: From: / / To: / /

Applicant #2

Employer: Phone #: Monthly Income (Gross):

Position: Supervisor: From: / / To: / /

FICO ______Income 30%______BKGRND______Emply Verified______Paid w______

Other Occupants (list ALL planning on living full or part time at residence):

Name: Relationship: DOB:

Others:

Pets on Property (list ALL that will be at the residence):

Number of Pets: Type(s): Weights:

Vehicles on Property (list ALL vehicles that will be parked at residence):

Make: Model: Year: Plate #: State:

Others:

Please check the appropriate answer that applies to you in the checkboxes:

All pets are current on all vaccinations and shots: Y/ N

Have you ever broken a lease agreement or have been evicted?: Y/ N

Are you in the process or planning to declare bankruptcy within the next year? Y/ N

Does anyone smoke cigarettes?: Y/ N

Have you ever been convicted of a crime, placed on probation, have a warrant
out for your arrest, or are currently involved in any criminal activity? Y/ N

Will you be cultivating marijuana on the premises: Y/ N

Applicant’s Signature : Date:
Applicant’s Signature: Date:

(Signatures cannot be typed and must be signed)