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Your Information
First Name:

Middle Name:

Last Name:

Social Security Number:

Driver's License #:

State Issued:
 Email Address:

Cell Phone::

Work Number:

Home Number:

Date of Birth:

Month

Day

Year

Co-Applicant Information
First Name:

Middle Name:

Last Name:

Social Security Number:

Driver's License #:

State Issued:

Email Address:

Cell Number:

Work Number:

Home Number:

Date of Birth:

Month

Day

Year
Current Address Previous Address

Street Address:

City:

State:

Zip:

Landlord's Name:

Landlord's Phone:

Reason for Moving:

Monthly Rent:
$
When did you move in?

When did you move out?


Do you rent this residence? Yes   No
Is your name on the lease? Yes   No
Have you given written notice to leave? Yes   No

Street Address:

City:

State:

Zip:

Landlord's Name:

Landlord's Phone:

Reason for Moving:

Monthly Rent:
$
When did you move in?

When did you move out?

Do you rent this residence? Yes   No
Is your name on the lease? Yes   No
Have you given written notice to leave? Yes   No
 
Your Current Employer
Name of Employer:

Address:

City:

State:

Zip:

 Your Supervisor:

Your Position:

Your Start Date:

Employer's Phone Number:

Monthly Salary:
      Gross     Net
Co-Applicant Current Employer
Name of Employer:

Address:

City:

State:

Zip:
 Co-Applicant Supervisor:

Co-Applicant Position:

Co-Applicant Start Date:

Employer's Phone Number:

Monthly Salary:
      Gross     Net
Your Personal History

Have you ever?...

been asked to move out or evicted? Yes   No
declared bankruptcy? Yes   No
been sued for damage to a rental unit? Yes   No



broken a rental agreement or lease? Yes   No
been sued for nonpayment of rent? Yes   No
been convicted of a felony? Yes   No

 
Other Residents:  List the legal names and ages of ALL other people who will occupy this unit.
Names & Ages:
Please Read Carefully
I hereby state and represent that the information in this application is complete and accurate.  I understand that in the event a lease is entered into it may be cancelled by the Landlord if any of the information provided in the application is materially inaccurate or incomplete.  I hereby authorize the Landlord or Landlord's agents to verify the information on the application.  Verification or re-verification of any information contained in the application will be retained by Landlord.  I hereby authorize Tenant Data Services Inc. to obtain information about me, including, but not limited to, this application, my credit, my tenant history, my check writing history, any court records and/or my criminal record, and I hereby authorize & instruct any entity or person contacted by Tenant Data Services Inc. or the Landlord or Landlord's agents to release such information to them.  Upon request, Landlord, Landlord's agents, or Tenant Data will provide the name & phone number of the source of the information used in the verification process.
Applicant:
 Date:
I agree to the above:   Yes       No