Rental Application - Ultra Agent



|Rental Application |

|Rental Information |

|Rental Price Range:       |Desired Type/Size:       |Desired Move-In Date:       |

|Rental Location:       |

|Applicant Information |

|Name:       |

|Date of Birth:       |SSN:       |Driver’s License/State:       |

|Work Phone:       |Mobile Phone:       |Military Status:       |

|Current Address:       |

|City:       |State:    |ZIP Code:       |

|Monthly Rent:       |How Long?       |Email:       |

|Current Landlord:       |Phone:       Fax: |

|Employment Information |

|Current Employer:       |

|Supervisor’s Name:       |Phone:       |Fax:       |

|Employer Address:       |How Long?       |

|City:       |State:    |ZIP Code:       |

|Position:       |Hourly Salary |Monthly Income:       |

|Additional Occupant(s) |

|Name:       |Email:       |

|Date of Birth:       |SSN:       |Relationship:       |Military Status:       |

|Name:       |Email:       |

|Date of Birth:       |SSN:       |Relationship:       |Military Status:       |

|Name:       |Email:       |

|Date of Birth:       |SSN:       |Relationship:       |Military Status:       |

|Emergency Contact (parent or nearest relative not residing with you) |

|Name:       |Phone:       |Email:       |

|Address:       |Relationship:       |

|Cosigner Information |

|Name:       |SSN:       |Current Employer:       |

|Date of Birth:       |Phone:       |Supervisor Name and Phone:       |

|Position:       |Hourly Salary |Monthly Income:       |

|Annual Income: | | |

|Vehicle Information |

|Make:       |Model:       |Year:      |Plate Number:       |

|Make:       |Model:       |Year:      |Plate Number:       |

|Pet Information |

|Please List Type of Pet(s):       |Breed/Weight:       |

|Disclaimer |

|Have you ever been convicted of a crime? |Have you ever been evicted? |

|If Yes, please explain:       | |

|I believe that the statements I have made are true and correct. I hereby authorize a credit and/or criminal check to be made, verification of information I provided and |

|communication with any and all names listed on this application. I understand that any discrepancy or lack of information may result in the rejection of this application.|

|I understand that this is an application for an apartment and does not constitute a rental or lease agreement in whole or part. I further understand that there is a |

|non-refundable fee of $30.00 and an extra $15.00 if a Cosigner is required, payable to Property Management Alliance to cover the cost of processing my application and I |

|am not entitled to a refund even if this application is not approved. I further understand that there is a non-refundable holding deposit to remove an apartment off the |

|market. |

| | |

|Signature of Applicant:       |Date:       |

REQUIRED DOCUMENTATION

1. This form must be completely filled out at the time of application. Incomplete applications without the required documentation WILL NOT BE ACCEPTED.

2. Applicant(s) must present a valid photo ID.

3. Two (2) recent consecutive Paystubs and/or proof of income or benefit.

4. If unable to verify your employment over the phone, your current employer must fill out an employment verification form. Please be sure to add a fax or email that we can use to send the form.

5. It is your responsibility to provide us with the information necessary to process your application. We reserve the right to deny your application if, after making a good faith effort, we are unable to verify your information.

6. This rental application and documentation provided will be kept on file for 60 days, after which will be discarded. Applicant must reapply after 60 days.

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