Keith Sells Houses

Rental Application

Your Local Real Estate Company Serving the Community

Rental Application

Important!!

Each adult (18 and over) must fill out a separate application!

Please fill out as much information as you can.

Fields with a * are required.

Remember, the more complete this application is the better we can serve you.

Address of the House or Apartment I am Applying for *

Personal Information

First Name *

Last Name

Date of birth *

Driver's License # *

Social Security # *

Phone *

Email *

All other proposed occupants: Name, age, relationship to applicant* *

Rental/Residency History

Current Address *

Address

Street Address

City

State

Country

Postal Code

Owner/manager Name *

Owner/manager Phone *

Reason for wanting to move *

Have you given notice yet? *

Been at present location since *

Previous Address *

Former Address *

City
State

Owner/manager Name & Phone # *

Dates of Residency *

Employment History

Current Employer *

Company Address

Company Phone *

Name of Supervisor *

Occupation *

Gross Monthly Pay *

Employed since *

Previous Employer *

Previous Company Address *

Previous Company Phone

Name of Previous Supervisor

Previous Occupation

Previous Gross Monthly Pay

Dates of Previous Employment

Credit History

Checking Account: Bank *

Checking Account: Balance *

Savings Account: Bank *

Savings Account: Balance *

Credit Card: Bank *

Credit Card: Balance *

Credit Card 2: Bank

Credit Card 2: Balance

Auto Loan: Bank *

Auto Loan: Balance *

Auto Loan 2: Bank

Auto Loan 2: Balance

If you are applying for one of our rent to own homes, much do you have for a down payment? *

Vehicles

Make, Model, Year and License Plate Number *

Vehicle 2: Make, Model, Year and License Plate Number

References and Emergency Contacts

By signing this application you grant us permission to communicate with all the contacts listed in this section in the event we can not locate you. Furthermore, if you abandon the premises for any reason then you grant us permission to allow your relative listed below to remove all contents of the dwelling on your behalf.

Doctor

Dr. Name

Dr. City

Dr. Phone

Lawyer

Lawyer Name

Lawyer Address

Lawyer Phone

Relatives

Relative 1 and Relationship *

Relative's City

Relative's State

Relative's Phone *

Relative 2 and Relationship

Relative 2's City

Relative 2's State

Relative 2's Phone

General Information

How long do you think you would be renting from us? *

When would you be able to move in? *

How many pets do you have? List breeds and approx weight. *

Do any of the people who would be living in the premises smoke? *

Have you ever been Evicted? *

Have you ever files for bankruptcy? If so, when *

Have you ever been convicted of a felony? *

List any verifiable sources of income you would like us to consider (optional).

If you were to run into financial difficulty in the future do and couldn't come up with the money to pay the rent, do you know someone who loan you the money? If so, provide their information so we can use them as a reference for you,

Reference Street Address

Reference City

Reference State

Reference Zip Code

Reference Phone

Is there anything else you would like us to know?

Agreement and Authorization Signature

I believe the statements I have made are true and correct. I hereby authorize a credit check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that this is a rental application only for an apartment/house and does not constitute a rental or lease agreement in part or whole. Any questions regarding rejected applications must be submitted in writing to Manager at address below.

Signature 18bg

Clear

Type you name and initials as your signature.

Date Signed

Manager: 33 Moeller Road, Picayune, MS 39466

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