Rental Application

The undersigned hereby makes application to rent: Beginning on: Monthly Rent:
Full Name:

A complete application consists of the following: 1. A completed Rental Application form for each adult that will be living in the home. 2. Proof of income for each adult application. 3. $40 non-refundable application fee per adult application.

Home Phone:

Date of Birth:

Social Security Number:

Work Phone:

Drivers License Number:

State:

Cell Phone:

Co-Applicant Name (separate application form):

Email Address:

Total number of occupants:

Names & ages of occupants:

Total number of pets:

Type of pet(s):

Breed:

Weight:

Age:

Current Address: m Rent m Owned

Month & Year Moved In:

Residence History (past 3 years)

City:

State & Zipcode:

Reason for Leaving:

Owner or Agent Name:

Phone Number:

Monthly Payment:

Previous Address (if within 3 years): m Rent m Owned

Month & Year Moved In:

City:

State & Zipcode:

Reason for Leaving:

Owner or Agent Name:

Phone Number:

Monthly Payment:

Employment Information

m Full time m Part-time m Student m Retired m Not Employed Position: Dates Employed:
From: To:

Current (or Most Recent) Employer:

Address

City, State, Zip

Gross Monthly Income:

Supervisor:

Phone Number:

Gross Household Monthly Income:

Vehicles

Total Number of Vehicles __________ Year: Color: Tag No: State:

Make/Model:

Have you or co-applicant ever: Been sued for non-payment of rent? m Yes

m No Been evicted or asked to move out? m Yes m No Broken a Rental Agreement or Lease? m Yes m No Declared Bankruptcy? m Yes m No Been sued for damage to rental property? m Yes m No Continued on next page.

Please give any additional information that might help management evaluate your application:

How did you hear about our property? If management has any questions about your application, please give phone numbers where you can be reached.
Day Phone: Night Phone:

I authorize Blackwell Property Management & Real Estate Services to contact previous landlord(s), credit, and personal references that I have given in this application. I also authorize Blackwell Property Management & Real Estate Services to obtain my consumer credit report. The above information, to the best of my knowledge, is true and correct.
Signature of Applicant: Date:

Office Use
Payment of $ Received by (name): Date: Date:

This application form received by (name):

Reference Verification Name

Reference Comments

This application

m Approved

m Not Approved Date:

By: Title: If not approved, specify reason(s):

Applicant Notified by (name): Notified by: m Letter (attach copy) m Phone m In Person