Prime Properties XL

RENTAL APPLICATION FOR RESIDENTS AND OCCUPANTS
After reading & accepting the Terms of Agreement, please fill out, and submit the form below.

Date:

Apartment Name: Apt. #:

Desired Date of Occupancy: Monthly Rental Rate:

Name of Applicant: Date of Birth (mm/dd/yy):

Social Security #: Driver's License #: Phone #:

Present Address: City: State: Zip:

Previous Home Address: City: State: Zip:

Name of Employer: Salary:

Address of Employer: Position: Phone #:

Name of Spouse: Date of Birth (mm/dd/yy):

Social Security #: Driver's License #: Business Phone #:

Name of Employer (spouse): Position: Salary:

Address of Employer (spouse): Name of Supervisor:

Other Sources of Income:

OTHER PERSONS WHO WILL OCCUPY THIS APARTMENT WITH YOU:
(Each lessee and occupant over 18 years old must submit a separate application.)

Name: Relationship: Birth date (mm/dd/yy):

Name of apartment where you now live: Owner or manager's name:

Their phone: Date moved in: Monthly Rent:

Why are you leaving your present residence?:

Your previous home address: City: State: Zip:

Apartment Name: Owner or manager's name:

Their phone: Monthly Rent:

Date moved in: Date moved out:

CREDIT REFERENCES:

Bank: Phone: Acct.#:

Other: Phone: Acct.#:

How many vehicles, boats or trailers would you keep at this address?

Make of car: Year: License #:

Do you have pets? Yes No Type: Weight: lbs. Do you have a waterbed? Yes No

Are you a member of the military? Yes No

In case of an illness, injury, death or non-payment of rent, please notify:

Name: Address: City: State: Zip:

Phone:

Relationship: