Personal Information:   
								
												
								First Name							 
														
								
												
								M.I.							 
														
								
												
								Last Name							 
														
								
												
								Social Security #							 
														
								
												
								Date of Birth							 
														
								
												
								Driver's License #							 
														
								
												
								Phone Number							 
														
								
												
								Alternative Number							 
														
								
												
								Email							 
														
								
					Co-Applicant:  				
								
												
								First Name							 
														
								
												
								M.I.							 
														
								
												
								Last Name							 
														
								
												
								Social Security #							 
														
								
												
								Date of Birth							 
														
								
												
								Driver's License #							 
														
								
												
								Phone Number							 
														
								
												
								Alternative Number							 
														
								
												
								Email							 
														
								
					Rental History  
								
					Current Address  
								
												
								Current Address (Street, City, State, ZIP)							 
														
								
												
								Move-In Date							 
														
								
												
								Landlord's Name							 
														
								
												
								Landlord's Phone							 
														
								
												
								Monthly Rent							 
														
								
												
								Reason for Moving							 
										
								
					Previous Address  
								
												
								Previous Address (Street, City, State, ZIP)							 
														
								
												
								Move-In Date							 
														
								
												
								Landlord's Name							 
														
								
												
								Landlord's Phone							 
														
								
												
								Monthly Rent							 
														
								
												
								Reason for Moving							 
										
								
					Previous Address  
								
												
								Previous Address (Street, City, State, ZIP)							 
														
								
												
								Move-In Date							 
														
								
												
								Landlord's Name							 
														
								
												
								Landlord's Phone							 
														
								
												
								Monthly Rent							 
														
								
												
								Reason for Moving							 
										
								
					Employment Information  
								
												
								Current Employer							 
														
								
												
								Position							 
														
								
												
								Employer Phone Number							 
														
								
												
								Supervisor Name							 
														
								
												
								Gross Wages Per Month							 
														
								
												
								Hire Date							 
														
								
												
								Other Sources of Income							 
														
								
												
								Amount Per Month							 
														
								
												
								Explain							 
										
								
					Questionnaire  
								
												
								How long will you live here?							 
														
								
												
								What pets do you have?							 
														
								
												
								How many evictions have been filed upon you?							 
														
								
												
								How many felonies do you have?							 
														
								
												
								Have you ever broken a lease?							 
														
								
								
												
								How many vehicles do you own?							 
														
								
												
								Is the total move-in amount available now?							 
														
								
												
								When would you like to move in?							 
														
								
												
								How did you hear about this home?							 
														
								
												
								For what reasons could you not pay rent on time?							 
														
								
								
												
								Balance							 
														
								
								
												
								Balance							 
														
								
												
								Emergency Contact Name							 
														
								
												
								Emergency Contact Phone							 
														
								
												
								Relationship (Including to contact regarding rent or tenancy.)							 
														
								
												
								Why should we rent to you?							 
										
								
												
								Additional Information (Please use this optional space for additional information, comments, or explanations.)							 
										
								
					Authorization 860-236-0641  Holding Fee  Qualification Standards  
Applicant authorizes release of all information to Landlord and agrees that the information provided in this rental application is true and correct. This authorization extends beyond the end of Applicant’s tenancy.  				
								
												
								Applicant's Name (typed name will serve as your Signature)							 
														
								
												
								Co-Applicant's Name (typed name will serve as your Signature)							 
														
								
												
								Today's Date							 
														
								
					
						
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