There is a non-refundable processing fee to apply.
RENTAL APPLICATION                                                           For details, see the Agreement & Authorization statement.
Full Name (First Middle Last)                                       Birth Date   Social Security #       Driver’s License #
                                                                                    - -
Any Other Names You Have Used In The Past                                     Home Phone               Cell Phone
                                                                                -   -                      -  -
Names Of All Other Proposed Occupants                               Birth Date   Relationship To Applicant

                             Current Residence                          Previous Residence                             Prior Residence
Street Address
City, State                           ,                                                   ,                                            ,
Zip Code
Last Rent Amount Paid
Owner/Manager Name
Owner/Manager Phone #             -   -                                          -            -                                -       -
Reason For Leaving
Is/Was Rent Paid In Full?        Yes       No                                    Yes               No                      Yes                  No
Did You Give Notice?             Yes       No                                    Yes               No                      Yes                  No
Were You Asked To Move?          Yes       No                                    Yes               No                      Yes                  No
Name(s) Utilities Billed To
Dates Of Residency          From        To                             From                   To                    From                   To
                                    Current Employment             Previous Employment                               Prior Employment
Employed By
Street Address
City, State                                    ,                                     ,                                             ,
Zip Code
Employer’s Phone                           -   -                             -       -                                     -       -
Name Of Supervisor
Monthly Gross Pay
Dates Of Employment                 From           To               From                 To                        From                To
                                                         Bank/Institution Name                             Account Balance / Balance Owed
Savings Account
Checking Account
Credit Cards
Auto/Home/Miscellaneous Loans
VEHICLES (Also include vehicles belonging to the other proposed occupants)
      Year                      Make                     Model                                          Color         License Plate (State & #)

8810 S. 9th St., Phoenix AZ 85042                                   Rental Application                                                           Page 1 of 2
                Reference/Emergency Contact 1                                   Reference/Emergency Contact 2                    Reference/Emergency Contact 3
Street Address
City, State          ,                                                                   ,                                               ,
Zip Code
Phone Number(s)    -   -                                                             -       -                                       -       -
By signing this application, you grant the landlord permission to communicate with all the contacts listed in this section in the event that you cannot be reached.
Furthermore, should you abandon the residence for any reason, you grant the landlord permission to allow the first contact listed here to remove all contents of the
residence on your behalf.

Have you ever been late paying rent? If so, when?                                                    Yes       No
Do any of the people who would be living in the residence smoke? 1                                   Yes       No
How long do you think you would be renting this residence?
Have you ever filed for bankruptcy? If so, when?                                                     Yes       No
When would you hope to move into the residence?
Have you ever been convicted of a felony?                                                            Yes       No
Have you ever been served an eviction notice? If so, when?                                           Yes       No
How many pets do you have (list type, breed, weight, age) 2

Have you had any recurring problems with your current landlord or any previous landlord? If yes, please explain.
  Yes      No
Why are you moving from your current address?

List any verifiable sources of income (and the amounts) you wish to have considered as evidence of financial stability.

If you were to run into financial difficulty in the future and could not come up with money to pay rent, do you know someone
who would loan you money? If so, provide the person’s name, address and phone number so that this person can be used as a
reference for you. If this person is listed at the top of this page, you can simply enter the name here.

Have you been a party to any lawsuits in the past? If yes, please explain.
   Yes      No
A credit check and criminal background check will be conducted. Are you aware of any negative findings from these checks
that you would like to comment on?
   Yes      No
How did you hear about this rental? If online, please specify the website and/or search criteria used.

If you have an email address that you would like to use for correspondence, please list it here.

                                                             Agreement & Authorization Signature
I believe that the statements I have made in this rental application are true and correct. I hereby authorize the conducting of credit and criminal
background checks, verification of information I provided, and communication with any names listed on this application. I understand that any
discrepancy or lack of information may result in the rejection of this application. I understand that this is an application for lease of a single-family
residence and does not constitute a rental or lease agreement in whole or in part. I further understand that there is a non-refundable fee of $35 per
individual or $43 per married couple to cover the cost of processing my application and conducting credit and background checks, and I am not
entitled to a refund, unless I am granted rental of the residence and sign a rental agreement. Any questions regarding a rejected application must be
submitted in writing.

                         Signature:                                                                                 Date:

Unless the processing fee is paid in cash, make the                                              Return completed rental application (and payment), to:
check, cashier’s check or money order payable to:                                                        Mason Convey & Andrea Allhands
        Mason Convey                                                                                     3116 E Shea Blvd #128, Phoenix AZ 85028

    Smoking is not permitted within the residence.
    Pets will be considered on a case-by-case basis. Allowed pets will be defined in the lease agreement. Small, non-destructive pets will typically be permitted.

8810 S. 9th St., Phoenix AZ 85042                                                        Rental Application                                                      Page 2 of 2

To top