Corey Chambers Team
Lease Application to Rent / Screening Fee
Each adult resident must complete an application and pay $30.00 for a credit report.
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Checkout
Applicant is completing application as a (check one):
Tenant
Tenant with co-tenant(s)
Guarantor / cosigner
Total number of applicants
Application to rent property at this address
*
Rent per month
$
Dollars
.
Cents
Proposed Move-in Date
MM
/
DD
/
YYYY
Full Name of Applicant
*
Date of Birth
*
MM
/
DD
/
YYYY
Social Security Number (no dashes)
Encrypted
Driver's License Number
*
State
*
Expires
*
MM
/
DD
/
YYYY
Mobile Phone Number
###
-
###
-
####
Other Phone Number
###
-
###
-
####
Email
*
Names of all other proposed occupants and relationship to applicant
Pets (number, type and size in lbs)
Auto Make, Model, Year, Licence Plate Number, State, Color
Other Vehicles
In case of emergency, person to notify
Address, City, State ZIP
If applicant has been a party to an unlawful detainer action or filed bankruptcy in the last seven years, explain the unlawful detainer action or bankruptcy
If applicant or any proposed applicant has ever been convicted of or pleaded no contest to a felony, explain the felony conviction or no contest plea
If applicant or any proposed occupant has ever been asked to move out of a residence, explain why occupant was asked to move out of a residence
RESIDENCE HISTORY
Current address, city, state ZIP
From
MM
/
DD
/
YYYY
To
MM
/
DD
/
YYYY
Name of Landlord or Manager
Landlord or Manager's Phone
###
-
###
-
####
Do you own this property?
No
Yes
Reason for leaving current address
Previous address, city, state ZIP
From
MM
/
DD
/
YYYY
To
MM
/
DD
/
YYYY
Name of Landlord or Manager
Landlord or Manager's Phone
###
-
###
-
####
Do you own this property?
No
Yes
Reason for leaving this address
EMPLOYMENT AND INCOME HISTORY
Current employer
Current employer address, city, state ZIP
From
MM
/
DD
/
YYYY
To
MM
/
DD
/
YYYY
Supervisor
Supervisor phone
###
-
###
-
####
Employment gross income per month
$
Dollars
.
Cents
Other income info
Previous employer
Previous employer address, city, state ZIP
From
MM
/
DD
/
YYYY
To
MM
/
DD
/
YYYY
Supervisor
Supervisor phone
###
-
###
-
####
Employment gross income per month
$
Dollars
.
Cents
Other income info
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