Name Address City, State, Zip Home Phone Work Phone Other/CellPhone Fax E-mail Soc Sec # Date of Birth Drv Lic State & # Do you smoke?
Name Relationship Phone #
Present Landlord Landlord Phone # How long there? Current Rent Lease expires Reason for moving
If you have been living at this address for less than 2 years, please fill in additional info below: Previous Address City, State, Zip Previous Landlord Phone #
Previous Address City, State, Zip Previous Landlord Phone #
Employer Address City, State, Zip Occupation How long there? Salary / yr Supervisor Phone #
If you have been employed at this company for less than 2 years, please fill in additional info below: Previous employer City, State, Zip Occupation Previous Supervisor Phone #
Previous employer City, State, Zip Occupation Previous Supervisor Phone #
List all persons who will occupy this apartment for more than a week at a time and whether they will be on the lease:
Name, Age, Relationship, on the Lease? Name, Age, Relationship, on the Lease? Name, Age, Relationship, on the Lease? Animal Name, Type, Weight Animal Name, Type, Weight
Have you ever been evicted, declared bankruptcy, forecllosed upon or been a party to any type of litigation? If yes give details: