RENTAL APPLICATION:
RENTAL APPLICATION
Equal Housing Opportunity
Every Person over the Age of 18 Must Fill Out an Application
PLEASE PRINT
The undersigned hereby makes an application to rent the following property (Apartment Address): ____________________________________________________________________________________. PLEASE TELL US ABOUT YOURSELF
Full Name________________________________________
__________ Home Phone ( ) ________________________
Date of Birth_________________________________ Social Security
Pets__________________________________________________________________________________________
Does anyone in your household smoke? Yes No
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address_______________________________Apt City__________________ State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving____________________________Rent $__________
Owner/Agent__________________________________________________Phone ( ) ____________________________
Previous Address (last 3 years)_________________________________________________________Rent $____________
Owner/Agent__________________________________________________Phone ( ) ____________________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past seven (7) years? Yes___________ No____________
Have you ever been evicted from a rental residence? Yes___________ No____________
Have you had two or more late rental payments in the past year? Yes___________ No____________
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________________________
Dates employed_______________________________ Employed as______________________________________________
Supervisor Name______________________________________________ Phone ( )______________________________
Salary $_________________per________________. (If employed by above less than 12 months, give name & phone of previous employer or school:________________________________________________________________________________.) If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application. Amount $___________________ Source/Contact Name__________________________________________________________
PLEASE LIST YOUR REFERENCES
Banking Accounts:
Name_________________ Type of Account_________________
Personal Reference or Emergency Contact:
Name _______________________ Address _______________________________________________
Phone _______________________ Relationship_______________________
Driver's License:
Your Driver's License Number_________________ State_________________
Vehicle Information:
Make / Model _________________Year _________________License Plate State_________________
ADDITIONAL INFORMATION:
Please give any additional information that might help owner/management evaluate this application?
______________________________________________________________________________________
______________________________________________________________________________________
Where may we reach you to discuss this application? Day Phone # ( ) ___________________________ Night Phone # ( )____________________________
I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application. The above information, to the best of my knowledge, is true and correct. Please sign: X__________________________________ __________________________________
Name of Applicant Date
AUTHORIZATION
Release of Information
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.
_____________________________________________
Name (please print)
X_______________________________________ __________________________
Signature Date
OFFICE NOTES: One application for everyone 18 years or older. Management Contact Number Monday through Friday 8 am to 5 pm: 608/386/6910
SOMEONE WILL CONTACT YOU IF YOU QUALIFY. Please Mail To:
Dan OR Liz Franzini
110 10th st. SOUTH
La Crosse, WI 54601
