Majestic Realty, LLC Rental Application

							                              Rental Application
                              KADIEM Properties
                                 P.O. Box 1882
                            Cape Girardeau Mo. 63702
                              573-340-5703 (Office)
                               573-837-1121 (Fax)


   A $20.00 non-refundable application fee is required per applicant for credit
   application to be completed. Every adult over the age of 18 must have credit
investigation. Completely fill out all spaces where information is required. Drivers
License and Social Security Card are required to complete the application process.
Any missed information may lead to a slower processing period. If you are applying
         for a lease option please indicate money available for option fee.


 Property Applying For: ________________________________________________

        Amount Available for Option Fee Payment: ___________________

                 Expected Move In Date: ____________________

                      Numbers where we may contact you:
       Home: _________________________ Name: ____________________
       Work: _________________________ Name: ____________________
       Cell: __________________________ Name: ____________________

         How Many People will Be Occupying the Property?:___________
         Name                    Relationship              Date of Birth




                Are all occupants U.S. Citizens?: _____ Yes ____ No
             If no, do occupants hold a green card?: ____ Yes ____ No

       Does Anyone That Will Be Occupying the Home Smoke?: Yes No
              Will Any Pets Be Occupying the Home?: Yes No
               If Yes How Many and Give Descriptions of Each?:

          Name                         Type               Vaccinations Up To Date
  **Proof of Vaccinations may be required in order to be approved for property



                                   Personal

Main Applicant: _________________________________________________________
Date of Birth: ____________________ Social Security: ________________________
Drivers License #: _______________________________ Valid Thru: _____________
Any other names used:____________________________________________________
Current Employer: ______________________________ Since: __________________
Address:________________________________________________________________
Job Description: ___________________________ Work Hours: _________________
Pay Rate: _________________________ Pay Format: __________________________
Supervisor: ________________________________ Phone: ______________________
Previous Employer: ______________________________________________________
Address:________________________________________________________________
Job Description: ___________________________ Work Hours: _________________
Pay Rate: _________________________ Pay Format: __________________________
Supervisor: ________________________________ Phone: ______________________
Dates of Employment:__________________ Reason For Leaving:________________

Co: Applicant: __________________________________________________________
Date of Birth: ____________________ Social Security: ________________________
Drivers License #: _______________________________ Valid Thru: _____________
Any other names used:____________________________________________________
Current Employer: ______________________________ Since: __________________
Address:________________________________________________________________
Job Description: ___________________________ Work Hours: _________________
Pay Rate: _________________________ Pay Format: __________________________
Supervisor: ________________________________ Phone: ______________________
Previous Employer: ______________________________________________________
Address:________________________________________________________________
Job Description: ___________________________ Work Hours: _________________
Pay Rate: _________________________ Pay Format: __________________________
Supervisor: ________________________________ Phone: ______________________
Dates of Employment:__________________ Reason For Leaving:________________

                                   Addresses

 Present Address: ________________________________________________________
 Rent - Since: _____________________ Monthly Rental Amount: ______________
Is the rent up to date? Yes No If No Please explain: _________________________
         Have you ever been more then 30 days late on your rent?: Yes No
         Have you given notice: Yes No Date of Notice: ______________
Have you been asked to leave? Yes No If Yes Please explain: _________________
Landlord Name: __________________________ Contact #: ____________________

 Previous Address: _______________________________________________________
 Rent - Since: _____________________ Monthly Rental Amount: ______________
Is the rent up to date? Yes No If No Please explain: _________________________
         Have you ever been more then 30 days late on your rent?: Yes No
         Have you given notice: Yes No Date of Notice: ______________
Have you been asked to leave? Yes No If Yes Please explain: _________________
 Landlord Name: __________________________ Contact #: ____________________

                                     Cars

Make/Model #1: __________________________ Year: _________ Color: __________
License Plate #___________State: _________ Lien Holder: _____________________

Make/Model #2: __________________________ Year: _________ Color: __________
License Plate #___________State: _________ Lien Holder: _____________________

                                    Income

Current Income: $________________ Source: ________________________________
Current Income: $________________ Source: ________________________________
Current Income: $________________ Source: ________________________________
Current Income: $________________ Source: ________________________________

                                Bank Account(s)

Bank Name: _______________________ Account # ____________________________
Bank Name: _______________________ Account # ____________________________

                               Credit Account(s)

Creditors Name: __________________________ Account # _____________________
       Payment $______________      Is Account Current: Yes□    No□
Creditors Name: __________________________ Account # _____________________
       Payment $______________      Is Account Current: Yes□    No□
Creditors Name: __________________________ Account # _____________________
       Payment $______________      Is Account Current: Yes□    No□

                                  Reference(s)

Name: ________________________________ Relation: ________________________
Address: _______________________________________ Phone #_________________
Name: ________________________________ Relation: ________________________
Address: _______________________________________ Phone #_________________
Name: ________________________________ Relation: ________________________
Address: _______________________________________ Phone #_________________

Answer and Explain any “YES answers with Names and Details:

Has any signer been sued for bills: Yes□ No□
________________________________________________________________________
________________________________________________________________________
Has any signer ever been bankrupt: Yes□ No□
________________________________________________________________________
________________________________________________________________________
Has any signer ever broken a lease: Yes□ No□
________________________________________________________________________
________________________________________________________________________
Has any signer ever been sued for eviction: Yes□ No□
________________________________________________________________________
________________________________________________________________________
Has any signer ever been convicted of a felony: Yes□ No□
________________________________________________________________________
________________________________________________________________________

Applicant authorizes KADIEM Properties, LLC or any of it’s subsidiaries to
contact past and present landlords, employers, creditors, credit bureau, neighbors
and any other sources deemed necessary to investigate applicant.

Applicant authorizes KADIEM Properties, LLC or any of it’s subsidiaries to run a
credit investigation and/or Criminal Background Investigation anytime before,
during, or after tenancy.

All the information is true, accurate and complete to the best of applicant’s
knowledge. Owner reserves the right to disqualify prospective tenant if information
is not as represented.

ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION
ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A
PHOTOCOPY OF THIS FORM AT ANY TIME

____________________________________________
Main Applicant                      Date


____________________________________________
Co-Applicant                        Date
KADIEM Properties, LLC its subsidiaries and assigns, mission is to adhere to policies that help to prevent unauthorized use of
your personal information; to maintain the accuracy of the information provided; and to protect the privacy of your
information. All information collected is utilized by authorized employees of KADIEM Properties, LLC and is kept on the
premises. Information collected may be used for collection purposes after tenancy has ended. We reserve the right to contact
you by email, fax or US Mail.