RENTAL APPLICATION FORM // DATA
 
 RENTAL ADDRESS:  EXPECTED MOVE-IN DATE:

APPLICANT INFO
 FULL NAME:  DOB:
 ADDRESS:
 PHONE (H):  PHONE (W):
 EMAIL:
 SSN #:  DL #:
 PREV. ADDRESS:

APPLICANT EMPLOYMENT INFO
 EMPLOYEER:
 ADDRESS:
 POSITION:  INCOME ($):
 DATE START:  PHONE #:
 PREVIOUS:
 ADDRESS:
 POSITION:  INCOME ($):
 START/LEFT:  PHONE #:
 OTHER INCOME:

APPLICANT PRESENT LANDLORD OR MORTGAGE COMPANY
 NAME:
 PHONE #:  RENT ($):
 MOVE-IN:  MOVE-OUT:

CO-APPLICANT PERSONAL REFERENCES
 NAME:  PHONE #:
 NAME:  PHONE #:

CO-APPLICANT INFO
 FULL NAME:  DOB:
 ADDRESS:
 PHONE (H):  PHONE (W):
 EMAIL:
 SSN #:  DL #:
 PREV. ADDRESS:

CO-APPLICANT EMPLOYMENT INFO
 EMPLOYEER:
 ADDRESS:
 POSITION:  INCOME ($):
 DATE START:  PHONE #:
 PREVIOUS:
 ADDRESS:
 POSITION:  INCOME ($):
 START/LEFT:  PHONE #:
 OTHER INCOME:

CO-APPLICANT PRESENT LANDLORD OR MORTGAGE COMPANY
 NAME:
 PHONE #:  RENT ($):
 MOVE-IN:  MOVE-OUT:

CO-APPLICANT PERSONAL REFERENCES
 NAME:  PHONE #:
 NAME:  PHONE #:

OCCUPANTS - PLEASE LIST ALL PEOPLE WHO WILL BE LIVING AT THE RENTAL PROPERTY

1 - PEOPLE
 NAME:  AGE:
 NAME:  AGE:
 NAME:  AGE:
 NAME:  AGE:
 NAME:  AGE:
 NAME:  AGE:
 NAME:  AGE:

2 - PETS
 TYPE:  BREED:  WEIGHT:

3 - VEHICLES
 BRAND:  MODEL:  YEAR:

ADDITIONAL INFO

BANK INFORMATION
 BANK NAME:  ACCOUNT:

HAVE ANY OF THE PEOPLE LISTED ABOVE BEEN:
 EVICTED:  BROKEN LEASE:  FILE BANKRUPCY:


 
TENANCY will be denied if any information is misrepresented on this application.
If misrepresentations are found after the rental agreement is signed, your rental agreement will be terminated.

   This is to advise that I, the applicant hereby authorize Central Realty Group & Properties to obtain a consumer credit report, to conduct a criminal record search, an eviction search and to make any other inquiries as deemed necessary in determining eligibility for tenancy and assessing credit worthiness.

   I understand the information set out in the rental application form may be used for purposes of responding to emergencies, ensuring the orderly management of the tenancy, complying with legal requirements, and for collection purposes should rent be left owing or rental property damaged at termination of lease or end of tenancy.

Applicant shall give Central Realty Group & Properties a non-refundable application fee in the amount of US $ 60.00