Address of rental property: ____________________________________________ Monthly Rental Amount: _$___________ Occupancy date: ________________ once approved, 1st months rent must be received within 24 hours to hold property/ agreement within 48 hours.
CONSUMER HISTORY APPLICATION & RECEIPT FOR ADVANCED COSTS
ALL APPLICANTS OVER THE AGE OF 18 MUST COMPLETE A SEPARATE APPLICATION.
On the date of application, Owner/Agent received $_________from the undersigned “APPLICANT’, who offers to rent the above property. Applicant AUTHORIZES VERIFICATION OF INFORMATION supplied by the applicant and all other sources available not limited to credit report and tenant screening. The amount charged is itemized as follows: 1. Actual cost of credit report, Unlawful Detainers, evictions, credit history, other background information and proceeding: $_________Total fee charged (may not exceed $45.60 per applicant): $__________ This fee charged is for the report is non-refundable and is not a deposit.
1.
Applicant: __________________________________________________________________________________________________
(Last Name) (First Name) (Middle Initial) (Sr., Jr., etc.)
Any other names used? ______________________________________________ Date of Birth _______/______/_______ Social Security #_________________________________ID#___________________________ State___________ D/L or 2. 3.
ID
ADDITIONAL OCCUPANTS: Name_______________________ DOB___/___/___ Name______________________ DOB___/___/___ Name_______________________ DOB___/___/___ Name______________________ DOB___/___/___ RENT HISTORY: a. Have you ever been party to an eviction? Yes No b. Filed Bankruptcy? Yes pets? Yes No cat#____ dog#____ other____ d. Do you have insurance? CAR Yes No HOME IF YES TO ANY OF THE ABOVE QUESTIONS, PLEASE EXPLAIN ON A SEPARATE PAGE No c. Do you have Yes No
4.
PRESENT ADDRESS: ___________________________________City__________________ State ____ Zip _________ Date in date ____/____/____ Move out date ____/____/____ Monthly rent__________________ Notice has been given to Owner/ Agent? Yes No Landlord/Agent Web address_____________________________________ Landlord/Agent _____________________________ Business #____________________ Cell # ___________________ Reason for moving: _________________________________________________________________________________________ PREVIOUS ADDRESS: __________________________________City__________________ State ____ Zip _________ Date in date ____/____/____ Move out date ____/____/____ Monthly rent__________________ Landlord/Agent _____________________________Business #____________________ Cell # ___________________
5.
If self-employed, legal name of business and/ or license #. 2 years income tax needed 6. Employment: Employer: _____________________________________________________________________________ Address: __________________________________________City ______________________ State _____ Zip _________ Employer Telephone # _____________________cell # __________________ Web address ________________________________ Union ___________________________ Pay Period ________________ Documental Income (monthly) $__________ 7. Previous Employer: ____________________________________________________ Phone #_______________________ Address: __________________________________________City ______________________ State _____ Zip _________ Additional Income Source: (contact-verify)________________________________________________________________________ General Credit Information: Auto 1. ______________________________ Year _________model ___________________license/state _____ loan amt _________ Auto 2. ______________________________ Year _________model ___________________license/state _____ loan amt _________ Bank: _________________________ Branch ___________ chk acct #____________________ savings acct # __________________ Bank: _________________________ Branch ___________ chk acct #____________________ savings acct # __________________ Card # _________________________ Balance _____________ Current/delinquent ______________ telephone # ________________ Card # _________________________ Balance _____________ Current/delinquent ______________ telephone # ________________
8. 9.
10. Personal References: These people will be called. Name: _________________________ Address: ______________________ Telephone # _______________ Cell # _______________ Name: _________________________ Address: ______________________ Telephone # _______________ Cell # _______________ Nearest Relative: __________________________ Relation _________________ Telephone #_____________ Cell #_____________ I declare that ALL information given in this application is true and correct. I authorize Estey Real Estate it verify and obtain complete consumer history report and supply information obtained to their clients. This information is not privileged. This information will not be sold. Date: _______________Cell # ___________________ Telephone # ___________________ Email: ___________________________ Signed: _______________________________________________________________________