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| Desired Rental Address/Building Name |
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| Personal Information |
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| *First Name: |
Middle Initial: *
Last Name:
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| Social Sec. #: |
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| *Date of Birth: |
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| Drivers License #: |
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| *Birth Place |
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| *Current Address: |
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| *Current City/State/Zip: |
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| *How Long at this Address: |
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| *Current Home Phone: |
* Cell
Phone:
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| Current Work Phone: |
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| *Current E-mail Address: |
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| Are you a Student? |
Yes No |
| *What year & Major? |
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| Do you have a pet? |
Yes No
If YES, what kind: |
| *Names of Roommates: |
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| Current Leasing Information |
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*Have you ever rented a house
or apartment: |
Yes No |
| Present Landlord's Name: |
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| Present Landlord's Phone #: |
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| Previous Address: |
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| Previous Address City/State/Zip: |
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| Previous Landlord's Name |
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| Previous Landlord's Phone: |
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| Legal Questions |
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Have you ever been evicted
from a rental unit? |
Yes No
If YES, why: |
*Have you ever been sued
for non-payment of rent? |
Yes No
If YES, why: |
*Do you currently have any
outstanding judgments
against you? |
Yes No |
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| Financial Background |
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| Have you ever failed to timely pay rent? |
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| Have you ever filed for bankruptcy? |
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Permanent Address Information
(Parents) |
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| *Parents' Names: |
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| Permanent Address: |
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| Permanent City/State/Zip |
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| Permanent Phone: |
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| Parent's Work Phone: |
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| Payment Information |
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| Share Your Responsibility for Rent?: |
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| Employment Information |
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| *Current Employer: |
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| Current Occupation: |
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| Full-Time or Part-Time |
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| Current Employer's Address: |
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| Employer's Contact Name: |
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| Current Employer's Phone: |
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| Length of Time with Employer: |
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| Current Salary |
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| *Current Source of Income: |
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| Spouse's Employer: |
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| Spouse's Employer's Address: |
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| Spouse's Employer's Phone #: |
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| Spouse's Wage: |
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| Vehicle Information |
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| Vehicle Make/Model: |
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| Vehicle License Plate #: |
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| State Vehicle is Registered: |
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| Emergency Contact Information |
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| *Emergency Contact's Name: |
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| *Emergency Contact's Relationship: |
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| *Emergency Contact's Phone: |
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| *Emergency Contact's Address: |
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| *Emergency Contact's City/State/Zip: |
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By typing "I agree" below, I certify that the answers are correct and
that I/We have accurately completed this application. I/We authorize Deckard
Homes and Apartments to conduct an employment/credit check and to obtain
any other reports necessary concerning me/us as deemed necessary concerning
my/our application and to verify all references. I/We understand that such
reports may include and are not limited to my credit history, civil and
criminal information, arrest records, rental history, employment and financial
history, vehicle records, licensing records, and any other information
deemed necessary. I/We declare that all information listed on this application
is true and accurate.
Date
I Agree
(Type "I AGREE")
Applicant's Full Name |
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| *Please enter the above image code: |
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