Date: ________________ Address Applying for 310 East Piedmont Street, Culpeper VA 22701 Last Name:__________________________

RENTAL APPLICATION
ONLY CLEAN & RESPONSIBLE PEOPLE WHO PAY RENT ON TIME MAY APPLY with valid Picture ID
RETURN TO:
DAWN DECOURCEY.

36 BETHANY WAY, FREDERICKSBURG, VA 22406

First Name: SSN: Cell Phone: Current Address: Owner/Manager: Moved In date: Previous Address: Owner/Manager: Moved In date: Previous Address: Owner/Manager: Moved In date: Current Employer: Position: Gross Wages:$ 2nd Job Employer: Phone: Date of Birth: Pager:

MI:

Last Name: Phone: Alternate Phone: City, State, Zip: Phone: Monthly Rent: Is this your phone?: Whose Phone?:

Jr.,Sr?

List your Addresses for the Previous 5 years

Why are you moving? City, State, Zip: Phone: Moved out date: City, State, Zip: Phone: Moved out date: Monthly Rent: Monthly Rent:

Employment and Income

How long will you rent here?: ___ 1 yr ___2 yr ___ 3 yr Your Attorneys Name: + Is the total move-in amount available now?: Have you broken a lease?: How many Evictions have been filed on you?: What may interrupt your income or ability to pay rent?

Are You a Convicted Felon?:

What kind of animals do you have?:

1.) 2.) 3.)

If accepted the following persons will be living with me 4.) 5.) 6.) Credit References Purpose of Loan Balance

Lender 1.) 2.)

Monthly Payment

Do you have a Checking Account?: Do you have a Savings Account?: Do you own Real Estate?:

NAME 1.) 2.)

EMERGENCY CONTACTS including help to pay rent ADDRESS PHONE

RELATIONSHIP

LIST Vehicles & Trailers your household will possess: ______________________________________________________________ HOW DID YOU FIND THIS HOME: (friend, yard sign, etc.) _____________ Your requested move-in date: _____________________ Do you have 1st months and security deposit: ?_____________Attach copy of your credit report found at www.annualcreditreport.com

Vista Software In A2 Application

Date: ________________ Address Applying for 310 East Piedmont Street, Culpeper VA 22701 Last Name:__________________________
Other comments or explanations:

This agreement made this date by and between______________________________., manager for the Owner, hereinafter Landlord and the below signed, hereafter Applicant. The Applicant shall pay to the Landlord nonrefundable fee upon the execution of this agreement in the amount listed on application to cover the administrative costs, expenses, and time of the Landlord to verify information submitted by the Applicant. Applicant authorizes the Landlord, his employees, agents, or representatives to make any and all inquiries necessary to verify the information provided herein, including but not limited to direct contact with Applicants employer, landlords, credit, neighbors, police, government agencies and any and all other sources of information which the Landlord may deem necessary and appropriate within his sole discretion. The Applicant represents to the Landlord that the application has been completed in full and all the information provided for herein is true, accurate and complete to the best of the Applicants knowledge and further, agrees that if any such information is not as represented, or if the application is incomplete the Applicant may, at the Landlord's sole discretion, be disqualified. The Applicant provides the information contained on this form. Landlord is not liable to the Applicant, his heirs, executors, administrators, or assigns for any damages of any kind, actual or consequential by reason of the verification by the Landlord of the information provided by the Applicant, and Applicant hereby releases the Landlord, his agent, employees and representatives from any and all actions, causes of action of any kind or nature that may arise by virtue of the execution or implementation of the agreement provided herein. This property requires a Security Deposit equivalent to one months rent plus $50.00 that must by paid in full before any rental agreement is made. Animal deposit(s) are in addition to security deposit. Applicant, once approved, must obtain renters insurance and Landlord will attempt to contact the Applicant by the phone numbers listed on this application. Applicant has 24 hours from time of approval to fulfill rental agreement by producing all monies required and signing all rental agreement papers. If Applicant fails to perform within 24 hours of Landlords approval, Applicant may be disqualified and Landlord may rent this home to the next qualified Applicant. Our required standards for qualifying to rent a home are simple and fair. They are: - All homes are offered without regard to race, color, religion, national origin, sex, disability or familial status. - Each adult occupant must submit an application. - Your gross monthly income must equal approximately three times or more the monthly rent - A favorable credit history. - Be employed and be able to furnish acceptable proof of the required income. - Good references, housekeeping, and property maintenance from your previous Landlords. - Limit the number occupants to 2 per bedroom. - Compensating Factors can include additional requirements such as double deposit or rent paid in advance for applicants who fall short of above criteria.

The Applicant authorizes release of all information to Landlord.

APPLICANT: _____________________________

DATE: _________

Received By:

App Fee

OFFICE USE ONLY, Do NOT Write Below This Line Viewed Property Picture ID Copy

Source

Vista Software In A2 Application

Date: ________________ Address Applying for 310 East Piedmont Street, Culpeper VA 22701 Last Name:__________________________

Vista Software Inc.

A2 Application

Vista Software In A2 Application