ApplicationForTenancy2016 PDF
ApplicationForTenancy2016 PDF
Move In Date:
Disqualified
Reason:
(319)236-1136
Date:
FULL NAME
PHONE (
DATE OF BIRTH
COAPPLICANT
PHONE (
DATE OF BIRTH
,
OTHER OCCUPANTS AND THEIR RELATIONSHIP (Unrelated adults must fill out a separate Rental
Application)
DO YOU HAVE PETS? IF SO, WHAT KIND?
RENTAL HISTORY
CURRENT ADDRESS:
Move in date
Reason for leaving:
CITY
Manager
STATE
Phone
ZIP
Monthly rent
PREVIOUS ADDRESS:
Move in date
Reason for leaving:
CITY
Manager
STATE
Phone
ZIP
Monthly rent
STATE
Phone
ZIP
Monthly rent
CITY
Manager
PREVIOUS ADDRESS:
Move in date
Reason for leaving:
EMPLOYMENT INFORMATION
STATUS:
Full-Time
Part-Time
Student
CURRENT EMPLOYER:
Unemployed
Position:
Supervisors phone:
_________ Amount:
Verification:
YOUR BANK:
TYPE OF ACCOUNT:
VEHICLE INFORMATION:
Make/Model
Year
Color
License Plate #
No
If you answered yes to any of the above please give a detailed explanation below:
EMERGENCY CONTACT: (please list your nearest relative not living with you)
Name
Relationship
Address
City
State
Zip
EVENING PHONE:
I hereby apply to lease the above described premises for the terms and upon the conditions set forth and agree that the rent is to be payable the first
day of each month, in advance. I warrant that all statements above set forth are true; however, should any statement made above be a
misrepresentation or not a true statement of facts, a portion of the deposit will be retained to offset the Landlords time, cost and effort in processing
my application.
Upon acceptance of this application, a deposit shall be retained as part or all of the security deposit. When so approved and accepted, I agree toexecute
a lease for ______ months. Any balance of the security deposit and first months rent shall be due on or before the day I take possession of the apartment.
After this application has been so approved and accepted, should I fail to execute a lease and fail to move in, I understand that this
deposit shall be applied to the Landlords cost, time, effort, lost rent, advertising, etc. and will not be refunded to me.
I hereby authorize the landlord, in processing this application, to check and verify the following:
1.
2.
3.
4.
By signing below, I hereby authorize the release of the information on this application in compliance with any city ordinance.
Signature of Applicant
Date
Signature of Applicant
Date
Deposit $
Received by
Date