ROOMS FOR  RENT

              TO START THE APPLICATION PROCESS, PLEASE FOLLOW THE LINK BELOW.

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ROOM RENTAL APPLICATION

APPLICANT

Full Name____________________________  D.O.B.____________Phone ________________

Social Sec. #   _____-____-_______  How long do you think you will stay with us? __________ Vehicle:   Year________Make________________ Model_______________ Color___________

Have you ever been served an eviction notice or asked to vacate the property?    NO / YES  Explain________________________________________________________          

Do you smoke?                                                                                                         NO / YES

Have you ever been arrested? NO / YES     

Have you ever been convicted of a crime?   NO / YES

CURRENT RESIDENCE__________________________________________________

How Long There_________ Name Of Landlord__________________ Phone ________________

Reason For Moving ______________________________________________________________

PRIOR RESIDENCE ______________________________________________________ How Long There_________ Name Of Landlord__________________ Phone________________

Reason For Moving______________________________________________________________

CURRENT EMPLOYMENT

Position________________ Employer_________________ How Long Employed*___________

Address______________________________________________Phone_____________________

Supervisor’s Name___________________ Salary (Week, Month, Year)_____________________

*If less than two years give prior employment information below

Position________________ Employer_________________ How Long employed_____________

Address______________________________________________Phone____________________

Supervisor’s Name___________________ Salary (Week, Month, Year)_____________________

EMERGENCY CONTACTS

                       Name             Phone    Relationship

1)___________________________    ______________________    _______________________

2)___________________________    ______________________    _______________________

3)___________________________    ______________________    _______________________

I/We offer the foregoing information as inducement to you to rent or lease Me/Us your rental unit.  UNDER PENALTY OF PERJURY, I/We declare said foregoing information to be true and correct and do hereby authorized you to conduct an employment and credit check and to verify our references.   Any misrepresentation on this application can be grounds for termination of tenancy.

SIGNATURE_________________________________DATE_____________________

We will reach out to you when your application is reviewed and decided upon.