Rental Application

PLEASE READ THIS FIRST
Call our friendly staff and bring your completed application to the appointment you schedule with our office along with $75.00 per person (18 or older) in the form of a cashier’s check or money order. Please call our office if you have any questions 772-267-2001.

* Required

FIRST NAME *

MIDDLE NAME

LAST NAME *

BIRTH DATE *

SS# *

EMAIL ADDRESS *	PHONE 1 *	PHONE 2 *

DRIVERS LICENSE # *
STATE *
OTHER NAMES EVER USED INCL. MAIDEN NAME

 

LIST ALL ADDITIONAL ADULTS AND CHILDREN	AGE	RELATIONSHIP TO APPLICANT

 

CURRENT ADDRESS
STREET *	UNIT #
CITY *	ST *	ZIP *
HOW LONG (MO/DA/YR) *  FROM:    TO:
LAST RENT PAID: * MONTH AMT
OWNER/MANAGER *
OWNER/MANAGER PHONE *
REASON FOR LEAVING *

PRIOR ADDRESS
STREET	UNIT #
CITY	ST	ZIP
HOW LONG (MO/DA/YR)  FROM:    TO:
LAST RENT PAID: MONTH AMT
OWNER/MANAGER
OWNER/MANAGER PHONE
REASON FOR LEAVING

 

EMPLOYMENT

	CURRENT EMPLOYMENT *
EMPLOYER *
ADDRESS *
EMPLOYER PHONE *
OCCUPATION/POSITION *
TYPE OF BUSINESS *
NAME OF SUPERVISOR *
DATES EMPLOYED *	FROM: TO:
MONTHLY SALARY *
OTHER INCOME *

	PREVIOUS EMPLOYMENT
	FROM: TO:

 

REFERENCES
NAME OF BANK/CREDIT UNION	BRANCH OR ADDRESS	ACCOUNT #		BALANCE
		CHECKING
		SAVINGS
		CHECKING
		SAVINGS
CREDIT CARD/CAR PAYMENTS	ADDRESS	ACCOUNT #	MO PMNT	BALANCE

 

PERSONAL REFERENCES	ADDRESS/CITY	RELATIONSHIP	TELEPHONE
EMERGENCY CONTACT *	ADDRESS/CITY *	RELATIONSHIP *	TELEPHONE *

 

ADDITIONAL INFORMATION	YES /NO
1. HAVE YOU EVER HAD ANY CREDIT PROBLEMS? *
2. HAVE YOU EVER HAD AN UNLAWFUL DETAINER (EVICTION) FILED AGAINST YOU? *
3. HAVE YOU EVER BEEN EVICTED FOR NON-PAYMENT OF RENT OR ANY OTHER REASON? *
4. HAVE YOU EVER FILED BANKRUPTCY? *
5. HAVE YOU EVER BEEN CONVICTED FOR SELLING, POSSESSING OR MANUFACTURING     ILLEGAL DRUGS? *
6. HAVE YOU EVER BEEN CONVICTED OF A FELONY? *
7. WILL YOU HAVE PETS? *      YES      NO  HOW MANY?    DESCRIBE
8. WILL YOU HAVE WATER-FILLED FURNITURE IN YOUR RESIDENCE? * DESCRIBE
9. PLEASE EXPLAIN ANY "YES" ANSWERS
11. HOW DID YOU HEAR ABOUT US? *
10. WHEN DO YOU PLAN TO MOVE IN? (DATE) *

 

AUTOMOBILES
AUTO #1
YEAR		COLOR
MAKE		LICENSE #
MODEL		STATE
AUTO #2
YEAR		COLOR
MAKE		LICENSE #
MODEL		STATE

 

I HEREBY APPLY TO RENT A HOUSE # AT

FOR $ PER MONTH AND UPON APPROVAL OF MY APPLICATION AGREE TO PAY THE FIRST

MONTH'S RENT OF $   AND A SECURITY DEPOSIT IN THE AMOUNT OF $ .

I WOULD LIKE A  GARAGE   CARPORT

If approved, applicant shall pay holding deposit and balance of first month rent and security deposit in the form of cashier's check or money order.

I authorize Robinhood Terrace/Paradise Residential to check my application using all the information I provided. *

Please type your name: *