Rental Application

* Applicant is completing Application as a (choose one) Tenant Tenant with co-tenant(s) Guarantor/co-signor

* Total Number of Applicants 1 2 3 4 5 6 7 8 9 10

* Application to rent property at (“Premises”)

* Rent: $ per Month Year Week Day
* Proposed move-in date / /

* Full Name of Applicant

* Date of Birth

* Social Security No.

* Driver’s License No. State Select One Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
* Expires / /

* Phone Number: Home Work
Other

* Email

* Name(s) of all other proposed occupant(s) and relationship to applicant

* Pet(s) or service animals (number and type)

* Auto: Make Model
Year License No.
State Color
Other Vehicle(s)

* In case of emergency, person to notify
Name Relationship
Address Phone

* Does applicant or any proposed occupant plan to use liquid-filled furniture? No Yes Type

* Has applicant been a party to an unlawful detainer action or filed bankruptcy within the last seven years? No Yes If yes, explain

* Has Applicant or any proposed occupant ever been convicted of or pleaded no contest to a felony? No Yes If yes, explain

* Has applicant or any proposed occupant ever been asked to move out of a residence? No Yes If yes, explain

* Current Address: (All Fields Required)
Street Address City/State/Zip
From / / To / /
Name of Landlord/Manager
Do you own this property? No Yes
Reason for leaving this address


* Previous Address (All Fields Required)
Street Address City/State/Zip
From / / To / /
Name of Landlord/Manager
Do you own this property? No Yes
Reason for leaving this address

* Please fill in the applicable fields

Current Employer
Company Supervisor
Phone number to verify employment
From / / To / /
Employer's Address
Position or Title
Gross income $ per Month Year Week Day

Previous Employer
Company Supervisor
Phone number to verify employment
From / / To / /
Employer's Address
Position or Title
Gross income $ per Month Year Week Day

Other Income
Other Income $ per Month Year Week Day
Source

* Please fill in the applicable fields

1st creditor
Name of creditor
Account Number
Mo/ Payment $ Balance Due

2nd creditor
Name of creditor
Account Number
Mo/ Payment $ Balance Due

1st bank account
Name of bank/branch
Account Number
Type of acct. Acct. balance

2nd bank account
Name of bank/branch
Account Number
Type of acct. Acct. balance

* Two references and all fields are required

1st Reference
Name Address
Phone Years acquainted
Occupation

2nd Reference
Name Address
Phone Years acquainted
Occupation

* At least one relative and all fields required

* 1st Relative
Name Address
Phone Relationship

* 2nd Relative
Name Address
Phone Relationship

Application Terms (please read carefully)

Applicant understands and agrees: (i) this is an application to rent only and does not guarantee that applicant will be offered the Premises; and (ii) Landlord or Manager or Agent may accept more than one application for the Premises and, using their sole discretion, will select the best qualified applicant.

Applicant represents the above information to be true and complete, and hereby authorizes Landlord or Manager or Agent to: (i) verify the information provided; and (ii) obtain credit report on applicant.

If application is not fully completed, or received without the screening fee: (i) the application will not be processed until fee is received and/or (ii) the application and any screening fee will be returned.

Applicant
Date Time

* By selecting yes you are confirming your application payment will be postmarked no later than 24 hours from the time of application submission No Yes (Yes Required)

Applicant is aware that there is a screening fee for submission. (The screening fee may not exceed $30.00 adjusted annually from 1-1-98 commensurate with the increase in the Consumer Price Index.) A CPI inflation calculator is available on the Bureau of Labor Statistics website, www.bls.gov. The California Department of Consumer Affairs calculates the application screening fee amount to be $37.57 as of 2006.

By typing your name below you understand and agree to the terms above and are confirming all of the information you entered is 100% truthful.

Applicant's Electronic Signature
Date