Rental Application - KLARK KOUNTY RECORDS 3235 S EASTERN AVENUE by lifemate

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									                         KLARK KOUNTY RECORDS
                           3235 S EASTERN AVENUE
                             LAS VEGAS, NV 89169
                     PH: (702) 894-9880 FAX (702) 894-9631


                            RENTAL APPLICATION

PROPERTY ADDRESS: ____________________________ MOVE-IN DATE: _____________

RENT:$_______     DEPOSIT: $ ______ PROCESSING FEE: $ ________

                                    APPLICANT

NAME: ___________________     DATE OF BIRTH ___________       SSN _____________

ADDRESS: _________________________ CITY: _________________________

STATE: _______    ZIP: _________      PHONE (   ) _________________

HOW LONG AT THIS ADDRESS: _________         RENT AMOUNT: $ ____________

REASON FOR LEAVING: ______________________________________________________

PRIOR STREET ADDRESS: _____________________________________________________

CITY: __________________________      STATE: __________ ZIP: _______________

REASON FOR LEAVING: ______________________________________________________

                                   AUTOMOBILE

MAKE ________________ MODEL __________________          LICENSE NO: ___________

                                   EMPLOYMENT

EMPLOYER _____________________________________          PHONE (   ) ____________

ADDRESS _________________________________         CITY ________________________

STATE __________ ZIP ________ SUPERVISOR’S NAME __________________________

HOW LONG EMPLOYED _________________         SALARY (MONTH) $ ______________

DUTIES _____________________________________________________________________
PREVIOUS EMPLOYER _________________________ PHONE (         ) _______________

HOW LONG EMPLOYED _____________            SALARY (MONTH) $ _____________

DUTIES ______________________________________________________________________

OTHER INCOME:     SOURCE ________________________ AMOUNT $ ______________

                  SOURCE ________________________ AMOUNT $ ______________

                        CURRENT BANK REFERENCE

NAME OF BANK ____________________________________________________________

ADDRESS _________________________________         CITY _______________________

STATE _________   ZIP ___________     ACCOUNT# _____________________________

                            CREDIT REFERENCES

NAME ________________________________      ACCT NO ____________________

ADDRESS _________________________ CITY ________STATE ____ ZIP ________

TYPE OF ACCOUNT ____________________________

NAME ________________________________      ACCT NO ____________________

ADDRESS _________________________ CITY ________STATE ____ ZIP ________

TYPE OF ACCOUNT ____________________________

NAME ________________________________      ACCT NO ____________________

ADDRESS _________________________ CITY ________STATE ____ ZIP ________

TYPE OF ACCOUNT ____________________________

                                   CO-APPLICANT

NAME: ___________________     DATE OF BIRTH ___________       SSN _____________

ADDRESS: _________________________ CITY: _________________________

STATE: _______    ZIP: _________      PHONE (   ) _________________
HOW LONG AT THIS ADDRESS: _________         RENT AMOUNT: $ ____________

REASON FOR LEAVING: ______________________________________________________

PRIOR STREET ADDRESS: _____________________________________________________

CITY: __________________________      STATE: __________ ZIP: _______________

REASON FOR LEAVING: ______________________________________________________

                                   AUTOMOBILE

MAKE ________________ MODEL __________________          LICENSE NO: ___________

                                 EMPLOYMENT

EMPLOYER _____________________________________          PHONE (   ) ____________

ADDRESS _________________________________         CITY ________________________

STATE __________ ZIP ________ SUPERVISOR’S NAME __________________________

HOW LONG EMPLOYED _________________         SALARY (MONTH) $ ______________

DUTIES _____________________________________________________________________

PREVIOUS EMPLOYER _________________________ PHONE (         ) _______________

HOW LONG EMPLOYED _____________             SALARY (MONTH) $ _____________

DUTIES ______________________________________________________________________

OTHER INCOME:      SOURCE ________________________ AMOUNT $ ______________

                   SOURCE ________________________ AMOUNT $ ______________

IN ADDITION TO APPLICANT(S), THE FOLLOWING PERSONS WILL BE LIVING
AT THE PREMISES:

        NAME                    RELATIONSHIP      AGE         OCCUPATION
   1.   ________________________________________________________________________
   2.   ________________________________________________________________________
   3.   ________________________________________________________________________
   4.   ________________________________________________________________________
   5.   ________________________________________________________________________
   6.   ________________________________________________________________________
HAVE YOU EVER FILED A PETITION FOR BANKRUPTCY? ________              IF YES,

PLEASE GIVE DETAILS ________________________________________________________

HAVE YOU EVER BEEN EVICTED? ________ IF YES, WHEN? _____________________

EXPLAIN ____________________________________________________________________

HAVE YOU EVER WILLFULLY REFUSED TO PAY RENT WHEN DUE? ____________

IF YES, EXPLAIN _____________________________________________________________

HOW LONG DO YOU PLAN TO LIVE HERE? _________         DO YOU HAVE ANY
PETS? __________ IF SO, DESCRIBE ___________________________________________

IN CASE OF EMERGENCY, NOTIFY _____________________________________________

PHONE ( ) _____________ ADDRESS ____________________________________________

CITY ___________________      STATE __________ ZIP _______________

NEAREST RELATIVE _________________________________________________________

PHONE _______________________      ADDRESS ________________________________

CITY ______________________   STATE _________   ZIP ______________


________________________           _________________________________________
DATE                               APPLICANT’S SIGNATURE

________________________           _________________________________________
DATE                               CO-APPLICANT’S SIGNATURE
                   PLEASE READ CAREFULLY BEFORE SIGNING

   1.   THE LANDLORD HAS THE RIGHT TO EITHER ACCEPT OR REJECT THIS APPLICATION. IF
        ACCEPTED, THE DEPOSIT WILL BE CREDITED TOWARD THE REQUIRED SECURITY
        DEPOSIT. APPLICANT ACKNOWLEDTES THAT THE SECURITY, PET, AND ANY OTHER
        DEPOSITS ARE A NON-INTEREST HOLDING DEPOSIT. IF REJECTED FOR ANY REASON, THE
        DEPOSIT WILL BE RETURNED. THE APPLICANT HEREBY WAIVES CLAIM FOR DAMAGE BY
        REASON OF NON-ACCEPTANCE OF THE APPLICATION.

   2.   APPLICANT UNDERSTANDS THAT AFTER ACCEPTANCE AND APPROVAL OF THIS
        APPLICATION, IF APPLICANT FAILS OR REFUSES TO PAY THE BALANCE OF THE FIRST
        MONTH’S RENT AND/OR THE BALANCE OF ALL DEPOSITS, WHEN REQURESTED BY THE
        LANDLORD OR HIS AGENT, OR FAILS TO EXECUTE MANAGEMENTS USUAL RENTAL
        AGREEMENT, OR REFUSES TO OCCUPY THE PREMISES ON THE AGREED UPON DATE,
        APPLICANT’S DEPOSIT WILL BE RETAINED TO COVER ANY EXPENSES OR RENT LOSS DUE
        TO HIS CANCELLATION.

   3.   LANDLORD AND AGENT WILL NOT BE BOUND BY ANY REPRESENTATIONS, AGREEMENTS
        OR PROMISES MADE BY LANDLORD OR AGENTS UNLESS CONTAINED IN THE WRITTEN
        LEASE OR RENTAL AGREEMENT SIGNED BY LANDLORD OR HIS AGENT.

   4.   APPLICANT DOES HEREBY RELEASE LANDLORD, HIS AGENT AND THIS COMPANY FROM
        ANY AND ALL DAMAGES OR LIABILITIES WHICH MIGHT RESULT FROM THE ABOVE
        INFORMATION OR VERIFICATION OR ATTEMPTED VERIFICATIION THEREOF, APPLICANT
        HEREBY AUTHORIZES ANY PRESENT OR FORMER LANDLORD TO GIVE ANY INFORMATION
        HE MAY HAVE REGARDING APPLICANT IN HIS CAPACITY AS LANDLORD. APPLICANT
        FURTHER RELEASES ANY SUCH LANDLORD OR FORMER LANDLORD FROM ANY AND ALL
        LIABILITY FOR ANY DAMAGE OR INJURY WHATSOEVER CAUSED FROM ISSUING THE
        SAME. APPLICANT FURTHER UNDERSTANDS AND AGREES THAT A FALSE STATEMENT
        HEREIN IS GROUNDS FOR DENIAL OF RENTAL. ALSO THE CORRECTNESS OF THE ABOVE
        STATEMENT AND VERIFICATION OF THE SAME ARE TO BE CONSTRUED AS A CONDITION
        PRECEDENT TO ANY BINDING RENTAL AGREEMENT OR CONTRACT BETWEEN APPLICANT
        AND THE LANDLORD.

   5.   APPLICANT REPRESENTS THAT ALL OF THE ABOVE STATEMENTS ARE TRUE AND
        COMPLETE AND HEREBY AUTHORIZES VERIFICATION OF THE ABOVE INFORMATION,
        REFERENCE AND CREDIT RECORDS. APPLICANT UNDERSTANDS THAT AN INVESTIGATIVE
        CONSUMER REPORT MAY BE PREPARED WHEREBY INFORMATION IS OBTAINED AS TO
        APPLICANTS CHARACTER, GENERAL REPUTATION, AND MODE OF LIVING.

   6.   APPROVAL FOR RESIDENCY IS MADE WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX,
        NATIONAL ORIGIN, AGE OR HANDICAP.


________________________________________________    __________________
SIGNATURE OF APPLICANT                                     DATE

________________________________________________    __________________
SIGNATURE OF APPLICANT                                     DATE

								
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