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For questions please call (970) 635-9224
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Name of Applicant |
Name of Co-Applicant |
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Date
of Birth
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Date of
Birth
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Social
Security No |
Social
Security No.
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Drivers
Lic. No.
Expir. Date |
Drivers
Lic. No.
Expir. Date |
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Current
Street Address
City/State/Zip
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Years
at present address
Current Rent
Landlord
Phone (
) - |
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Previous
Street Address
City/State/Zip
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Years
at previous address
Previous Rent
Landlord
Phone (
) - |
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Home
Telephone ( )
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Do
you plan to use a water bed?
Yes ____
No ____ |
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Occupants |
Occupant
1:
Relationship |
Information
on Pet: Type
/ Breed: Age:
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Occupant
2:
Relationship |
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Occupant
3:
Relationship |
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Occupant
4:
Relationship |
Does
any proposed occupant smoke?
Yes _____
No _____ |
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Car
Make
Year
Model
Color
License
No. |
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Car
Make
Year
Model
Color
License
No. |
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EMPLOYMENT
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APPLICANT’S
OCCUPATION* |
CO-TENANT’S
OCCUPATION |
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Employer |
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How
long in this job |
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Business
Phone # |
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Type
of Business |
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Position
held |
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Name
of Supervisor |
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Supervisor’s
Phone # |
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Monthly
Gross Income |
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v
If
employed for less than two years, give same information for prior occupation.
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INCOME
2 SOURCE (Please
Name Source) |
INCOME
2 AMOUNT (Per
Month) |
INCOME
3 SOURCE (Please
Name Source) |
INCOME
3 AMOUNT (Per
Month) |
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Applicant |
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Co-Applicant |
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Total |
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CREDIT
REFERENCES
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Credit
Reference (Name
of institution) |
Credit
Type (Auto,
Credit Card…) |
Account
# |
Current
Balance |
Current
Payment (Monthly) |
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Has the applicant or co-applicant ever filed a petition for bankruptcy?
________________________________________________________
Has the applicant or co-applicant ever been evicted from any tenancy?
_______________________________________________________
Has the applicant or co-applicant ever willfully and intentionally refused
to pay any rent when due? Yes _____
No _____
v
I DECLARE THAT THE FOREGOING
INFORMATION IS TRUE AND CORRECT.
v
I AUTHORIZE M.P. FENNELLY,
KAREN FENNELLY OR ALIKA PROPERTIES TO VERIFY THE ABOVE INFORMATION.
v
I AUTHORIZE M.P. FENNELLY,
KAREN FENNELLY OR ALIKA PROPERTIES TO OBTAIN A CONSUMER CREDIT REPORT.
v
I
agree that Landlord may terminate any agreement entered into in reliance on any
misstatement made above.
Applicant
__________________________ Date:
__________ Applicant
__________________________ Date:
__________