Rental Application

* 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

EMPLOYMENT

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) *

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: *