RENTAL APPLICATION
LANDLORD INFORMATION Application Date: ______/_______/_______ Landlord’s Name: __HILO_Management_LLC_________________________________ Landlord’s Phone: (_319_)_354_6372__ Landlord’s Email: info@hilomanagement.com_ Rental Address: Mailing Address: _1100_Oakcrest_Street,_Iowa City, IA 52240__ _2181_Brown Deer Road, Coralville, IA 52241__
APPLICANT INFORMATION Primary Applicant Name: __________________________________________________ Date of Birth: _____/_____/_____ Social Security No: ______-_____-______ Current Address: ________________________________________________________ City: _____________________ State: __ Zip:_______ Phone: (____)_________ Email: ____________________________________ Marital Status: __Single __Married __ Divorced __ Widowed Driver’s License No.: _____________________________ State Issued: _________ Co-Applicant Name: Current Address: ___________________________________________________
Date of Birth: _____/_____/_____ Social Security No: ______-_____-______ ________________________________________________________ City: _____________________ State: __ Zip:_______ Phone: (____)_________ Email: ____________________________________ Marital Status: __Single __Married __ Divorced __ Widowed Driver’s License No.: _____________________________ State Issued: _________ Co-Applicant Name: Current Address: ___________________________________________________
Date of Birth: _____/_____/_____ Social Security No: ______-_____-______ ________________________________________________________ City: _____________________ State: __ Zip:_______ Phone: (____)_________ Email: ___________________________________________________ Marital Status: __Single __Married __ Divorced __ Widowed Driver’s License No.: _____________________________ State Issued: _________ Previous Address (list from most recent to oldest) Address: _________________________________________ From: _______ to: ______ City: ______________________________ State: ______ Zip: __________-_______
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Landlord’s Name: _______________________ Landlord’s Phone: (____)____________ Landlord’s Address: _______________________________________________________ City: ______________________________ State: ______ Zip: __________-_______ Previous Address (list from recent to oldest) Address: _________________________________________ From: _______ to: ______ City: ______________________________ State: ______ Zip: __________-_______ Landlord’s Name: _______________________ Landlord’s Phone: (____)____________ Landlord’s Address: _______________________________________________________ City: ______________________________ State: ______ Zip: __________-_______ Children’s Names: 1. ____________________________________________________ 2. ____________________________________________________ 3. ____________________________________________________ 4. ____________________________________________________ Ages: _________ _________ _________ _________
List Type of Pets: ________________________________________________________ Applicant’s Employer(s): ________________________ ________________________ Co-Applicant’s Employer(s): ________________________ ________________________ Co-Applicant’s Employer(s): ________________________ ________________________ Phone Number: _______________________ _______________________ Phone Number: _______________________ _______________________ Phone Number: _______________________ _______________________ Job Title: ____________________ ____________________ Job Title: ____________________ ____________________ Job Title: ____________________ ____________________
Monthly Income: $________________ Monthly Income: $________________ Monthly Income: $________________
Source: ___________________________ Source: ___________________________ Source: ___________________________
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Bank Name: ___________________ ___________________ ___________________
Branch Address: _____________________________ _____________________________ _____________________________
Account Type: ____________________ ____________________ ____________________
Personal References (non family): __________________________________________ __________________________________________ __________________________________________ __________________________________________ Motor Vehicle(s) Make: ______________________ ______________________ ______________________ General Information Year: ______ ______ ______ Color:
Phone Number: ____________________ ____________________ ____________________ ____________________ License: State:
_________ ______________ ________ _________ ______________ ________ _________ ______________ ________
1. Have you received Welfare assistance in the last 2 years? ___ Yes ___ No 2. Have you received Unemployment Compensation in the last 2 years? ___ Yes ___ No 3. Are you eligible for Government Housing Subsidy? ___ Yes ___ No 4. Have you ever been evicted or ejected from a previous residence? ___ Yes ___ No 5. Was any person on this application ever arrested for anything other than a minor traffic violation? ___ Yes ___ No CERTIFICATION & AUTHORIZATION I certify that the information on this application is complete and true. I authorize verification of all information on this application. I also authorize the landlord named on this application the right to obtain a credit report and seek additional information from other sources. I agree that this application may be accepted or rejected at the discretion of the landlord. I understand and agree that all rental deposits will be refunded by the landlord, if this application is rejected. I understand and agree that the rental application fee will not be refunded for any reason.
Signature: __________________________________ Signature: __________________________________ Signature: __________________________________
Date: __________ Date: __________ Date: __________
Please send the application back to: Hilo Management, 2181 Brown Deer Rd., Coralville, IA 52241
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