APPLICATION FOR TENANCY

 

PLEASE PRINT THIS FORM, COMPLETE AND SIGN IT, AND FAX TO 563-332-6910 ALONG WITH RECENT PAY STUBS

 

How did you learn about the vacancy? (check one)   ____ Newspaper Ad  ____ Internet ____ For Rent Sign ____ Other

 

Address Applying For:_____________________________ Desired Move-In Date:___________________

 

List Name, Age, and Relationship of everyone who will occupy the home:

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

 

Please print clearly

APPLICANT #1

APPLICANT #2

Full Name:_____________________________________ SSN_____-___-_________  Date of Birth___/___/______ Current Address/City/Zip:__________________________ _______________________________________________ Dates: Mo__ Yr____ to Mo__ Yr____  Rent: $_________ Landlord’s Name/Phone:__________________________ Reason for Moving:______________________________ Home Phone:_____________ Cell Phone:_____________ Previous Address/City/Zip:_________________________ _______________________________________________ Dates: Mo__ Yr____ to Mo__ Yr____  Rent: $_________ Landlord’s Name/Phone:__________________________ Reason for Moving:______________________________ Employer’s Name:_______________________________ Employer’s Address/City/Zip:______________________ ______________________________________________ Job Title:______________________________________ Supervisor’s Name/Phone:_________________________ Subject to Transfer:  ____ Yes  ____ No;  Shift ____ Monthly Pay: $_________________ Dates of Employment:____/___/_____ to ___/___/_____ Other Income Sources:____________________________ Approximate Monthly Amount(s): $__________ For How Long? ____________ Outstanding Loans: $___________________ Total Owed Total Monthly Payments on Loans: $_____________/mo

Full Name:_____________________________________ SSN_____-___-_________  Date of Birth___/___/______ Current Address/City/Zip:__________________________ _______________________________________________ Dates: Mo__ Yr____ to Mo__ Yr____  Rent: $_________ Landlord’s Name/Phone:__________________________ Reason for Moving:______________________________ Home Phone:_____________ Cell Phone:_____________ Previous Address/City/Zip:_________________________ _______________________________________________ Dates: Mo__ Yr____ to Mo__ Yr____  Rent: $_________ Landlord’s Name/Phone:__________________________ Reason for Moving:______________________________ Employer’s Name:_______________________________ Employer’s Address/City/Zip:______________________ ______________________________________________ Job Title:______________________________________ Supervisor’s Name/Phone:_________________________ Subject to Transfer:  ____ Yes  ____ No;  Shift ____ Monthly Pay: $_________________ Dates of Employment:____/___/_____ to ___/___/_____ Other Income Sources:____________________________ Approximate Monthly Amount(s): $__________ For How Long? ____________ Outstanding Loans: $___________________ Total Owed Total Monthly Payments on Loans: $_____________/mo

 

Check one.  If you answer “Yes” to any of the following questions, please explain in the space provided below.  These questions apply to ANYONE who will be living in the house.

Yes	No
		Have your rent payments ever been late?
		Have you ever been evicted?
		Do you plan an in-residence business activity?
		Can you obtain a Co-Signer if necessary?
		Do you have/expect to have pets?
		Do you read English?  If not, name & # of person completing App:________________________________
		Do you own a waterbed(s)?
		Ever convicted of theft or robbery?
		Ever convicted on a charge involving Illegal use, abuse, possession, manufacture  or distribution of a controlled substance or plead “No Contest” to any drug and/or alcohol charges?
		Ever convicted of a felony or aggravated misdemeanor?
		Ever convicted of a sex offense requiring registration?  On any state’s sex offender list?
		Ever been a defendant in a Forcible Entry & Detainer (FE&D) [eviction] action?
		Ever been a defendant in a money judgment for Unpaid Rent/Utilities?  Damages?  Non-Compliance?
		Any adverse Credit conditions/situations in recent history that will show up on a Credit Report?

 

Explanation(s):___________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

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Utilities in either Applicant’s Name:  ___ Water ___ Sewer ___ Garbage Pick Up ___ Gas ___Electric ___ Other

Equipment Owned:  ___Vacuum Cleaner ___ Lawn Mower ___ Snow Blower/Shovel ___Sponge Mop

# of Cars:___  Number of Licensed Drivers:___
Names:____________________________________________________________

Make#1___________ YR#1____ License#____________
Make#2____________ YR#2____ License#____________

Non-Relative Reference:____________________________________________
Address:______________________________________________________ Phone:_____________

Nearest Living Relative:____________________________________________
Address:______________________________________________________ Phone:_____________

Emergency Contact:_______________________________________________
Address:______________________________________________________ Phone:_____________

 

I authorize Landlord to check information for verification by all available means (including, but not limited to): consumer reporting agencies, public records, current/previous rental property owners, employers, personal references.  Reverification or investigation of preliminary findings is not required.  If any of my answers are found to be incorrect, my application may be rejected and/or any Rental Agreement becomes null & void and will be sufficient reason for eviction & loss of security deposit.  I also authorize verification of Employment, Military Status, Bank Accounts, Credit History (including Credit Bureau Reports), Criminal Records, Rental History, Income, Evictions/Judgments, Student Status.  I declare that my Rental History and Credit records are in good standing and understand that if I am accepted and fail to complete this transaction by promptly signing any required papers, any deposit will be forfeited.

 

 

Signatures:

 

_________________________________________________          ____________________________

Applicant #1                                                                                                                             Date

 

_________________________________________________          ____________________________

Applicant #2                                                                                                                             Date