RENTAL APPLICATION

RENTAL APPLICATION
UNDER CONSTRUCTION Do Not Use

Neatly complete all information below.

All applicants over the age of 18 must complete and sign their own application

Please Fill in before printing

Rental applications

When you find a place where you want to live, you'll probably be asked to fill out a rental application. The application normally will ask for your current and past addresses, current and past employment, credit references, criminal history and other information the property owner or manager needs to make sure that you can afford to pay the rent and that you don't pose any risks to the property or the other residents.

Application fees and application deposits

In most cases, you will be charged an application fee to cover the cost of processing your application: running credit checks, verifying rental histories, etc. This fee is non-refundable.

You may also be asked to pay an application deposit. This deposit does not become a part of your security deposit until your application is approved and the lease is signed by both parties. If your application is not approved, the application deposit is refundable in most cases. However, depending on the application you fill out, the deposit may not be refunded if you are accepted but fail to move in; you fail to tell the truth on your application, or for certain other reasons.

Standard Full Verified Confirmation Fee: Individual - $42.00

Includes: Credit Report, Criminal Background Check, Eviction History, Check Writing, plus Person to Person verification of previous Rental History and Employment.

Application Date:

Please Select From the property listed, which one you applying for:

2 Bedroom Mobile Home
       192 Airakara Lane
       Cape Girardeau, MO 63701
       Brookwood Mobile Home Par

1 Bedroom Mobile Home
      2731 State Highway V
      Cape Girardeau, MO 63701
      Brookwood Mobile Home Park

General Information About You
(Exactly as on driver’s license or govt. ID card)

Name:

Full Middle:

Last:

Address:

City:

State:Zip

Your Age: Are you a U.S. citizen? Yes No

Home Phone: Cell Phone:

Business Phone: Fax Number:

Best Time to Call:Email:

How often do you check e-mail?

Preferred Way to contact: Home Cell Text Email Work

Social Security #: Birthday:

Driver License #:

Are you: Married Single Divorced Widowed Separated

Previous Last Names (Maiden and/or Married):

Personal Characteristic: Sex: Male Female

Weight: Height: Hair Color: Eye Color:

Do you have Pets?: Yes No If Yes, What Kind

Do you Smoke ?: Yes No

Do you Drink ?: Yes No If Yes, Explain How Much:

Do you use a waterbed ?: Yes No

Are you on prescription meds ?: Yes No

Number of occupants that will be living here?: Adults Children:

Do You have a Past or Existing Substance Abuse (Drugs, Alcohol)? Yes No If Yes, Explain

Criminal History:

Have You Ever Been charged, detained, or arrested for a felony OR sex crime that was resolved by conviction,
probation, deferred adjudication, court ordered community supervision, or pretrial diversion? Arrested for a felony or sex
related crime If Yes, We may need to discuss more
facts before making a decision. (Explain)?

Employment History

Current Employer and Address		Past Employer and Address
Supervisor:		Supervisor:
Work Phone:		Work Phone:
Start Date:		Start Date:
How Long:		How Long:
Job Title:		Job Title:
Rate of Pay:		Rate of Pay:
Weekly Income:		Weekly Income:
		Date Job Ended:
	For verification you will need the last three payroll stubs	Reason For Leaving:

Automobiles

First Car		Second Car:
Year		Year:
Make:		Make:
Model:		Model:
Color:		Color:
Vin #		Vin #
License Plate #:		License Plate #
Loan Holder on Car and Address		Loan Holder on Car and Address
Policy or Account #		Policy or Account #
Amount of Loan		Amount of Loan
Monthly Payments		Monthly Payments
Amount Left		Amount Left

Banking and Financial Information
Banking
Bank 1		Bank 2
Branch or Location		Branch or Location
How Long		How Long
Checking Account		Checking Account
Current Check #		Current Check #
Saving Account		Saving Account
Loans and Student Loans
Financial Intuition		Financial Intuition
Policy or Account #		Policy or Account #
Amount of Loan		Amount of Loan
Monthly Payments		Monthly Payments
Amount Left		Amount Left
Unsecured Credit
Financial Intuition Credit Cards		Financial Intuition Credit Cards
Policy or Account #		Policy or Account #
Amount of Loan		Amount of Loan
Monthly Payments		Monthly Payments
Amount Left		Amount Left
Financial Intuition Credit Cards		Financial Intuition Credit Cards
Policy or Account #		Policy or Account #
Amount of Loan		Amount of Loan
Monthly Payments		Monthly Payments
Amount Left		Amount Left

Have you declared Bankruptcy Yes No If so when:
Existing Credit Problems: Yes No Explain:
Your Rental History

	Landlord Full name	Landlord Phone	Landlord Address	Date Moved In	Date Moved Out	Rent Amount
Current
Past
Past
Have you moved out of a dwelling before the end of the lease term without the Landlord’s consent? (Explain)?
Have you been evicted or asked to move out? (Explain)?
Have you been sued for property damage? (Explain)?
Why are you leaving your current residence? (Explain)?
Personal Reference

Name	Address	Phone

AUTHORIZATION

I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize assigned agencies to: verify, by all available means, the above, including reports from consumer reporting agencies before, during and after tenancy on matters relating to my lease, and income history and other information reported by employer(s) to any state employment security agency. Work history information may be used only for this Rental Application. Authority to obtain work history information expires 365 days from the date of this Application. I authorize investigation of all statements contained in this application for tenant screening as may be necessary in arriving at a tenant decision, I understand that the landlord may terminate any rental agreement entered into for any misrepresentations made above.

Acknowledgment. You declare that all your statements on the first page and every page of this Application are true and complete. You authorize us to verify same through any means, including consumer reporting agencies and other rental housing owners. If you fail to answer any question or give false information, we may reject the application, retain all application fees and deposits as liquidated damages for our time and expense, and terminate your right of occupancy. Giving false information is a serious criminal offense.

Signature___________________________________________Date________________

Received from applicant the non-refundable sum of $___ _dollars to pay for tenant screening service

Application Fee (nonrefundable). You have delivered to our representative

a non-refundable application fee in the amount indicated above.

Signature_________________________________________Date________________

Terms

The Management or Agent submitting this application hereby listed, hereby attests he/she is an authorized personnel of a property whereby the applicant is hereby requesting consideration to rent/lease property and applicant has signed an application providing the property to authorize the necessary investigative effort for consideration, which includes a credit and criminal check and other verification as may be deemed necessary for the requesting property. The authorized agent is hereby requesting the services of this agency and attests that he/she has full authority to bind the requesting property to the fee(s) related thereof. This agency requires that a faxed signed application be sent within 48 hours of the application request. Said application should contain, at minimum the applicant’s full name, SSN, the Property's name and MUST have the applicant’s signature.

Signature_________________________________________Date________________

Landlord signs here