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					Diablo Properties P.O. Box 1133 Wilkes-Barre, Pa. 18703-1133 (570) 793-6724 joe@diabloproperties.com Date of Application _______/________/________ Referred by ______________________ Desired Address______________________________________________________________ Apartment number ________ Lease Term _____________ Move in Date ______/______/______ Rent $ _________ Each applicant must submit separate application. Credit checks are performed on all applicants. An application fee of $50.00 is charged on all applications turned down. A deposit of $____________ including an application fee of $50.00 is submitted with this application. Name (last)__________________________(first)______________________(Mi)_______ Date of birth______________ SS #_________-_______-_______________ Driver's License State _________ #____________________________________ E-Mail Address ___________________________________________________ Present Address_________________________ City_________________ State ______ Zip Code____________ Phone Number_______________________ Rent ____ own _____ how long? ________________ Payment / mo. $___________ Reason for Moving_______________________________________________________ Present Landlord___________________________Address___________________________ Landlords Phone Number_______________________________ Previous Landlord__________________________Address___________________________ Phone Number___________________________ Name of each person who will occupy the rental with you. 1) __________________________Age____ 3) __________________________Age____ 2) _________________________Age ____ 4) _________________________Age ____

Employer _____________________________________ Supervisor _________________________________ Position__________________________ Phone Number__________________ Length of Employment______________ Salary $__________ /month Additional Income $____________ If less than three years previous employer. Employer ______________________________________ Supervisor _________________________________ Phone Number___________________ Position _________________________ Length of Employment______________ Salary $ / month Emergency Contact Information Contact person__________________________________________Relationship____________ Phone #______-_______-____________ Address_________________________________________________________ _________________________________________________________ Credit References Credit Accounts______________________________ Payment $_________________ Phone__________________ Store acct. etc.______________________________________ Payment $_________________ Phone _________________ Bank name (savings)___________________________________________________________ Phone __________________ Bank name (checking)__________________________________________________________ Phone __________________ Credit Card (Circle one) Mastercard VISA Am. Express other___________________

Have you ever been late with your rent payments? Yes _______No_______ Have you ever been evicted? Yes ______ No ______ Have you ever been arrested? Yes ______ No ______

Vehicle Make_______________________________ Year________ License Plate_________________ Do you have or intend to have any pets? Yes _____No _____ how many Type_________ Lbs.______ An additional pet deposit of $__________ will be required. Also an additional charge of $_______/ mo. Yes/No Do you have... waterbed _____ air conditioner _____ washer/dryer _____ List other references Not Related to you, and who have known you for at least three- (3) years or more. All references will be contacted Name __________________________________________ Address _____________________________________________ Phone___________________________

Name __________________________________________ Address _____________________________________________ Phone___________________________

Name __________________________________________ Address ______________________________________________ Phone___________________________ If any of the above information is found to be false, any rental agreement becomes void and will be sufficient reason for eviction and loss of security deposit. Also I authorize Diablo Properties to verify my employment, bank accounts, credit history and criminal record. I declare that my rental and credit history is in good standing. I understand that if I am accepted and fail to complete this transaction by signing the lease my deposit will be forfeited in full. I have received a copy of Protect Your Family from Lead in Your Home and the lease. Applicant signature ________________________________________ Date _____________ Applicant signature ________________________________________ Date______________

Property manager/Owner________________________________ Date ___________
Form of ID  Drivers Lic.  School ID  Work ID  Other ________________________

Security Deposit Pet Deposit (if applicable) Rent TOTAL DUE Today's Deposit Total Balance Due

$___________ Due upon acceptance $___________ Due upon acceptance $___________ Due upon signing lease $___________ $___________ $___________ As of today ___________

United Credit Bureau Score


				
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posted:11/27/2009
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