ROOM APPLICATION

1

Name

First Name

Last Name

2

Phone Number

Area Code

Phone Number

3

Date of Birth

Date

4

Want to move in on

Date

5

Desired length of stayjust to get an idea

Less than 3 months

3 months to 6 months

more than 6 months

6

AddressCurrent Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

7

Landlords name and phone

8

How long did you live at current address

9

Reason for leaving current address

10

Current employerName, address, phone

11

Current employerPosition, How long employed, Salary

12

Have you ever been evicted or asked to leave a property you lived in.

yes

no

13

Do you smoke

Yes

No

14

Have you ever been convicted of a crime.

Yes

No

15

Have you ever been arrested

Yes

No

16

RESIDENT’S RENTAL AGREEMENT * This field is required.Please Read Terms and Conditions!

17

SignatureI/We offer the foregoing information as inducement to you to rent or lease Me/Us your rental unit. UNDER PENALTY OF PERJURY, I/We declare said foregoing information to be true and correct and do hereby authorized you to conduct an employment and credit check and to verify our references. Any misrepresentation on this application can be grounds for termination of tenancy.

Clear

18