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Your name:
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Date:
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Your email address:
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Your work phone number:
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Your phone number:
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Are you of legal age (18 or older) to sign a Rental Agreement? yes/no
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Address you are applying for:
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Your current address:
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Amount of rent at current address:
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How long at this address?
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Reason for moving:
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Manager for this address:
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Manager's phone number:
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Your previous address:
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Amount of rent at previous address:
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How long at previous address?
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Reason for leaving previous address:
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Manager for previous address:
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Previous manager phone:
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Names of all persons under 18 years of age, who will live with you:
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Names of persons, over 18 years of age, who will live with you.
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Company:
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Present occupation
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How long with present employer?
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Present employer name:
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Present employer phone:
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Previous Employer name and number:
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Current gross income per month, before deductions:
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Other sources of income?
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Any pets?
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Describe:
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Have you ever been evicted?
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If so, explain:
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If so, when?
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Have you ever filed bankruptcy?
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Do you, or does anyone living with you, smoke?
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Have you ever been convicted of a felony?
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Explain felony:
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Number of vehicles:
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Makes, models, years:
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Vehicle License Numbers:
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Contact in case of emergency name:
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Contact phone number:
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I declare that the statements above are true and correct, and I hereby authorize verification of references
given, a criminal, and a credit check.
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Signed:
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Date:
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Comments:
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