RENTAL APPLICATION by S1av5moR

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									                                                                                                              Fax or email completed
                                      RENTAL APPLICATION FOR COMPANIES                                             application to
                                                                                                                Fax #: 702-360-2631
                                                                                                           KarenLVNV@embarqmail.com


Company Name:
Mailing Address:
Employer Identifcation # (EIN)                                         How long have you been in business?
Contact Person:                                                                        Title:
Email Address:                                                                  Telephone:
Company Website Address:

RENTAL OCCUPANTS (Names/Children’s Ages):
                                Name                                                 Cell Phone (if Adult)              Age (if Child)




OCCUPANT VEHICLE(S):
(1) Make:                          Model:                      Year:             License #                          Color:
(2) Make:                          Model:                      Year:             License #                          Color:

MISCELLANEOUS:
Time period requested for rental:
Do you have pets?    Yes      No If Yes, describe (breed, weight)
Do any of the occupants smoke?     Yes     No (smoking allowed only on the patio)
Comments:



OCCUPANTS EMERGENCY CONTACT INFORMATION:
Name:                                                                                Relationship:
Address:                                                                              Telephone:

I hereby certify and affirm that all information provided above is true and correct. I fully understand that my lease or rental agreement
may be terminated if I have made any false, misleading or incomplete statement in this application. I hereby authorize verification of
all information provided in this application.

AUTHORIZED COMPANY REPRESENTATIVE:


Print Name                               Title                           Signature                                     Date

                                                                                                                      Revised 5/26/09

								
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