Rental Application Applicant - $35 Co Applicant $10 Rental Application Fee is Non-Refundable
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1 Rental Application Applicant - $35 Co Applicant $10 Rental Application Fee is Non-Refundable Date: / / Interviewed By: Property applying for: Move Date: / / Name of Applicant: Telephone ( ) - Social Sec No. - - Driver s License No. Date of Birth / / Name of Co-Applicant: Telephone ( ) - Social Sec No. - - Driver s License No. Date of Birth / / Name of Co-Applicant: Telephone ( ) - Social Sec No. - - Driver s License No. Date of Birth / / 1
2 Current Address City State Zip Code How long have you lived at current address? Years Months Name of Landlord Telephone ( ) - Previous Address City State Zip Code How long did you live at previous address? Years Months Previous Landlord Telephone ( ) - How many in your family? Adults Children Pets: Cat(s) Dog(s) Size lbs. Breed Applicant Employer Position How long? Years Months Telephone ( ) - Gross Monthly Wages Bank Name Telephone ( ) - Address City State Zip 2
3 Co-Applicant Employer Position How long? Years Months Telephone ( ) - Gross Monthly Wages Bank Name Telephone ( ) - Address City State Zip Co-Applicant Employer Position How long? Years Months Telephone ( ) - Gross Monthly Wages Bank Name Telephone ( ) - Address City State Zip Personal References Name Relationship Telephone ( ) - ( ) - ( ) - 3
4 Number of vehicles (including Company Cars) 1. Make Model Year Color Tag No. State 2. Make Model Year Color Tag No. State Have you ever Filed for Bankruptcy? Yes No If yes, when? Been served an eviction notice or been asked to vacate a property or owe money to someone for whatever reason may result in a declined application. An eviction on your record will result in automatic decline of application, as well. Yes No If yes, when and why? Do you know of anything which may interrupt your income or ability to pay rent? Yes No If yes, when and why? DISCLOSURE I hereby certify that the answers I have given in this application are true and correct to the best of my knowledge. I understand that any false answers or statements made by me will be sufficient grounds for eviction and loss of any security deposit. I give Carolina Landmark Realty, LLC the authority to obtain any information necessary to complete my application to include a credit report. Discrimination It is against the law to discriminate against tenants on the basis of race, religion, national origin, age, or neighborhood racial makeup. Applicant: _ Date: Co Applicant: 4 Date:
5 Employment Verification Name of Applicant: Place of Employment: Address: City: State: Zip: Phone ( ) - Supervisor Name: Hours worked per week: Pay Rate/Salary: $ Comments Applicant permits and agrees to by his/her signature below to allow Carolina Landmark Realty to obtain previous and current employment verification: Signature Date 5
6 Tenant Information Name of Applicant: Current Address/Name of Complex: City: State: Zip: Time at Current Address: years months Current Rent: $ per week month other: Does the Tenant Pay Rent on Time? Comments Applicant permits and agrees to by his/her signature below to allow Carolina Landmark Realty to obtain previous and current tenant verification: Signature Date 6
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