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Name
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Last
Birthday
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Social Security Number
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Drivers License Number
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Any Other Names You've Used in the Past
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Email
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Cell Phone
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Home Phone
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Other Proposed Occupants
Occupant Name
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Occupant Name
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Occupant Name
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Occupant Name
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Birthday
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dd/m/yyyy
Birthday
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mm/dd/yyyy
Birthday
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mm/dd/yyyy
Birthday
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Relationship to Applicant
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Relationship to Applicant
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Relationship to Applicant
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Relationship to Applicant
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Rental/Residence History
Current Residence
Address Line 1
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Address Line 2
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City
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State
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Zip
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Last Rent Paid
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Owner/Manager
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Owner/Manager Phone Number
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Reason for Leaving
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Is was rent paid in full?
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Did you give notice?
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Were you asked to move?
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Name in which your utilities are now billed?
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How long did you live here?
Start Month
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April
May
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July
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November
December
Start Year
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End Month
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May
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October
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December
End Year
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Previous Residence
Previous Address Line 1
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Previous Address Line 2
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Previous City
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Previous State
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Delaware
Florida
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Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Previous Zip
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Previous Rent Paid
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Previous Address' Owner/Managers Name
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Previous Address' Owner/Managers Phone
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Reason for Leaving Previous Address
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Was this previous rent paid in full?
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Yes
No
(Previous Address) Did you give notice?
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(Previous Address) Were you asked to move?
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(Previous Address) Name in which the utilities are now billed.
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How long did you live here?
(Previous Address) Start Month
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January
February
March
April
May
June
July
August
September
October
November
December
(Previous Address) Start Year
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(Previous Address) End Month
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January
February
March
April
May
June
July
August
September
October
November
December
(Previous Address) End Year
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Employment History
Employer Name
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Employer Address Line 1
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Employer Address Line 2
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Employer City
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Employer State
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Michigan
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Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Zip
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Phone Number
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Occupation
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Name of Supervisor
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Monthly Gross Pay
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Start Month
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January
February
March
April
May
June
July
August
September
October
November
December
Start Year
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End Month
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Option 1
Option 2
Option 3
End Year
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Previous Employer
Employer 2 Name
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Employer 2 Address Line 1
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Employer 2 Address Line 2
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Employer 2 City
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Phone Number
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Employer 2 Occupation
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Employer 2 State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Employer 2 Zip
*
Name of Supervisor
*
Monthly Gross Pay
*
Employer 2 Start Month
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January
February
March
April
May
June
July
August
September
October
November
December
Employer 2 Start Year
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Employer 2 End Month
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
Employer 2 End Year
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References/Emergency Contacts
Reference 1 Name
*
Reference 1 Relationship
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Reference 1 Phone Number
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Reference 2 Name
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Reference 2 Relationship
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Reference 2 Phone Number
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Emergency Contact Name
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Emergency Contact Relationship
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Emergency Contact Phone Number
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Additional Questions
Have you ever been served a late fee or notice?
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Yes
No
Do any of the people living with you smoke?
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Yes
No
How long do you think you will be renting from us?
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Have you ever filed bankruptcy? If so, when?
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When would you be able to move in?
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Have you ever been convicted of a felony?
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Yes
No
Have you ever been served an eviction notice? If so, when?
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How many pets do you have (list Type, Breed, approx Weight & Age)?
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Have you had any reoccurring problems with your current apartment or landlord? If yes, please explain:
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List any verifiable sources and amounts of income you wish to have considered (optional):
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Why are you moving from your current address?
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If you were to run into financial difficulty in the future and couldn’t come up with the money to pay the rent, do you know someone that would loan you the money? If so, provide the person’s name, address, & phone # so that we can use them as a reference for you.
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Have you been a party to a lawsuit in the past? If yes, please explain why:
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We may run a credit check and a criminal background check. Is there anything negative we will find that you want to comment on?
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How did you hear about this rental unit?
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Do you have an e-mail address we can reach you at?
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Do you know of anybody else looking for an apartment? Please provide their name and number. If you refer a friend and you each end up renting separate apartments from us then we will pay you a referral reward.
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