Rental / Credit Application - Keller Williams Realty
Rental / Credit Application
PERSONAL INFORMATION Date ___________________________________________ Interviewed By _______________________________________________ Name of Applicant _________________________________________________ Date of Birth ________________________________ E-mail____________________________________________Telephone___________________________________________________________ Social Sec.No.________________________________________________ Driver's License No. _________________________________ Present Address _________________________________________ City _____________________ State _________ Zip ___________ Prior Address _________________________________________ City _____________________ State _________ Zip____________ How long have you lived at present address?_________________ How long have you lived at prior address? _________________________ Name of Landlord __________________________________________ Telephone __________________________________________ PriorLandlord_____________________________________________Telephone_____________________________________________ How many will be living in this unit? Adults_____________ Children ____________ Pets ___________ Weight of pets ____________ Employer _________________________________________ Occupation ___________________________ Current Salary __________ How long?____________________________ContactPerson____________________________Telephone________________________
SPOUSE INFORMATION Name of Spouse __________________________________________ Date of Birth ______________ Telephone __________________ Social Sec. No. __________________________________________ Driver's License No. _________________________________________ Employer ____________________________ Occupation ____________________________CurrentSalary________________________ How long? ____________________________ Contact Person ____________________________ Telephone _____________________ Has your spouse ever filed for bankruptcy? q Yes q No BANK INFORMATION BankName_________________________________________________ Branch ___________________Telephone _________________ Address ___________________________________________________________________________________________________ Checking Account No. ________________________________ Savings Account No. _______________________________________
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? 2004, Socrates Media, LLC LF305 ? Rev. 04/04
PERSONAL / CREDIT REFERENCES
NAME
RELATIONSHIP
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
CREDIT GRANTOR
ADDRESS
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
_____________________________________________ ___________________________________
TELEPHONE ___________________ ___________________ ___________________
TELEPHONE ___________________ ___________________ ___________________ ___________________ ___________________
OTHER INFORMATION Number of vehicles (including company cars) _______________________________________________________________________ Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______ Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______ Make/Model______________________________________ Year_______ Color __________ Tag No. ______________ State _______
HAVE YOU EVER
Filed for bankruptcy q Yes q No
If yes, when? ______________________________________________________
Been served an eviction notice or been asked to vacate a property you were renting? q Yes q No
Willfully or intentionally refused to pay rent when due? q Yes q No If yes, when?____________________________________
Been sued for unlawful detainer? q Yes q No
How were you referred to us? q Newspaper (name) ________________ q Realtor (name) ____________ q Other ______________
Rental Unit applied for__________________________________________________________________________________________
Commencement date ________________________ Term _____________________ Rent/Month _______________________
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? 2004, Socrates Media, LLC LF305 ? Rev. 04/04
ACKNOWLEDGEMENT
I/We, the undersigned, understand that __________________________________ is the leasing agent and representative for the owner/landlord and that the leasing agent's fees will be paid by the owner/landlord. The undersigned acknowledge that this written notice was received prior to the undersigned receiving a lease agreement.
________________________________________________
Applicant's Signature
Date
______________________________________________
Co-Applicant's Signature
Date
CONSENT TO OBTAIN CREDIT / EMPLOYMENT INFORMATION
I/We authorize __________________________________, to investigate my/our credit qualifications and hereby release, in any manner, all of the information obtained by you. I/We further release all persons, agencies, or firms from any liabilities resulting from providing such information.
I/We declare under penalty of perjury that the information listed in this application is true and correct.
Executed on this ________ day of _________________________, 20_____, in the city of __________________, state of __________.
________________________________________________
Applicant's Signature
Date
____________________________________________
Co-Applicant's Signature
Date
The undersigned authorizes landlord, leasing agent, and representatives of owner/landlord to contact the undersigned's current or previous landlord, and current employer, and further, by a copy of this Application, authorizes any said landlord or employer to release pertinent residential and employment history information to be used in evaluating my lease application. I further authorize owner/landlord, leasing agent or its representatives to apply for or obtain an investigation or credit report in connection with this application. I understand that said investigation or credit report may contain information obtained from various state governmental and private entities relative to the undersigned's number of children, employment, occupation, general health, financial, and criminal history information.
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? 2004, Socrates Media, LLC LF305 ? Rev. 04/04
FOR OFFICE USE ONLY ? DO NOT WRITE BELOW
Application Verification
q Present Landlord q Previous Landlord q Applicant's Employment q Co-Applicant's Employment q Bank q Reference (1) q Reference (2) q Reference (3) q Other q Driver's License/ID q Credit Bureau
Person Contacted
Remarks
Verification completed by: _______________________________ Date: ______________________________________________ Remarks: ___________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________
MONIES RECEIVED
Date
Description
Amount
Application Fee
Security Deposit
THIS APPLICATION: q Is Approved q Is Not Approved
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? 2004, Socrates Media, LLC LF305 ? Rev. 04/04
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