Rental Application

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					                               Rental Application
_______________________________________________________________________


Address of Property to Be Rented: 5178 Martus, North Branch, MI 48461.


Rental Term: Lease from _____________ to __________________.


Amounts due prior to occupancy:

   First month's rent:                      $700

   Security deposit:                        $700

   Propane deposit:                         $700

   Credit check fee:                        $30

   Total:                                   $2,130

_______________________________________________________________________


Applicant

Full Name (include all names you use(d)): ____________________________________


Home Phone: ________________________Work Phone: ________________________


Social Security Number: __________________________________________________


Driver's License Number/State: _____________________________________________


State ID: _______________________________________________________________


Vehicle Make: ___________ Model: __________ Color: _________ Year: __________


License Plate Number/State: _______________________________________________




                               Rental Application — Page 1
Additional Occupants

List everyone, including children, who will live with you.


Full Name                                     Relationship to Applicant _____________

_______________________________________________________________________


_______________________________________________________________________


_______________________________________________________________________


_______________________________________________________________________


Rental History

Current Address, Street: ___________________________________________________


City: _________________________ Zip Code:____________________


Dates Lived at Address: From________To___________


Reason for Leaving: ______________________________________________________


Landlord/Manager: ________________ Landlord/Manager's Phone: _______________


Previous Address: _______________________________________________________


Dates Lived at Address: From________To___________ Reason for Leaving: ________


______________________________________________________________________

Landlord/Manager: ________________ Landlord/Manager's Phone: _______________

                                 Rental Application — Page 2
Employment History

Name and Address of Current Employer: _____________________________________


______________________________________ Phone: __________________________


Name of Supervisor: ______________________ Supervisor's Phone: ______________


Dates Employed at This Job: From__________To____________


Position or Title: ________________________________________________________


Name and Address of Previous Employer: ____________________________________


______________________________________ Phone: __________________________


Name of Supervisor: ______________________ Supervisor's Phone: ______________


Dates Employed at This Job: From _________To_________


Position or Title: ________________________________________________________


Income

1. Your gross monthly employment income (before deductions):    $________________


2. Average monthly amounts of other income (specify sources):   $________________


TOTAL:                                                          $________________




                               Rental Application — Page 3
Credit and Financial Information

Bank/Financial Accounts                  (“Yes” or “No” )        Bank/Institution_ Branch


Savings Account:


Checking Account:


Money Market or Similar Account:




                            Type of Account           Name of    Amount         Monthly
Credit Accounts Loans       (Auto loan, Visa, etc.)   Creditor    Owed           Payment


Major Credit Card: _______________________________________________________


Major Credit Card: _______________________________________________________


Loan (mortgage, car,

student loan, etc.): ________________________________________________________


Other Major Obligation: ___________________________________________________


_______________________________________________________________________


Miscellaneous

Describe the number and type of pets you want to have in the rental property:


_______________________________________________________________________


Describe water-filled furniture you want to have in the rental property:


_______________________________________________________________________

Do you smoke?           ___ yes          ___ no

                                   Rental Application — Page 4
Have you ever:


   Filed for bankruptcy? ___ yes ___ no      Been sued?___ yes ___ no


   Been evicted?___ yes ___ no     Been convicted of a crime?___ yes ___no


Explain any "yes" listed above. _____________________________________________


_______________________________________________________________________


References and Emergency Contact

Personal Reference: ______________________________ ________________________


Relationship: ___________________________________________________________


Address: ______________________________________ ________________________


Phone: ________________________________________________________________


Personal Reference: ______________________________ ________________________


Relationship: ___________________________________________________________


Address: ______________________________________ ________________________


Phone: ________________________________________________________________


Contact in Emergency: ____________________________ ________________________


Relationship: ___________________________________________________________


Address: ______________________________________ ________________________


Phone: ________________________________________________________________




                                 Rental Application — Page 5
I certify that all the information given above is true and correct and understand that my

lease or rental agreement may be terminated if I have made any material false or

incomplete statements in this application. I authorize verification of the information

provided in this application from my credit sources, credit bureaus, current and previous

landlords and employers, and personal references. This permission will survive the

expiration of my tenancy.


Date:_________________

Applicant Signature:________________________________________




Notes (Landlord/Manager): ________________________________________________


_______________________________________________________________________


_______________________________________________________________________


_______________________________________________________________________


_______________________________________________________________________


_______________________________________________________________________




                                  Rental Application — Page 6
Consent to Background and Reference Check

I authorize Lisa or Adam Kerschenheiter to obtain information about me from my credit

sources, current and previous landlords and employers, and personal references, to enable

Lisa or Adam Kerschenheiter to evaluate my rental application. I authorize my credit

sources, credit bureaus, current and previous landlords and employers, and personal

references to disclose to Lisa or Adam Kerschenheiter information about me that is

relevant to Lisa or Adam Kerschenheiter's decisions regarding my application and

tenancy. This permission will survive the expiration of my tenancy, when accessed for a

legitimate business purpose related to my tenancy.




___________________________________________

Name


________________________________________________________________

Address, City, Zip Code


___________________________

Phone Number


___________________________

Date


____________________________________________________
Applicant Signature



                    Consent to Background and Reference Check — Page 1

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