Today's Date * Date of Anticipated move in * Monthly Rent * Security Deposit * Pet Deposit Pet rent per month Applicant Email * Telephone Number * Date of Birth * Social Security Number * Driver's License Number * Color, Make & Model of your vehicle * License Plate Number * Occupants under 18 living with you Applicant's Employment Name of Current Employer * Contact Name and Phone Number * Date Started * Monthly Income * Other Sources of Income Previous Residences (3 Years) How Long Years and Months * Monthly Payment * Landlord * Landlord Telephone Number * How Long Years and Months Monthly Payment Landlord Landlord Telephone Number Emergency Contact Phone * Reason for leaving your current residence? * How did you find out about our rental? * Have you given legal notice where you live now? * Do you intend to have house pets at this residence? * Have you ever been evicted in the last 5 years? * If you have been evicted please explain: * Have you ever been convicted, plead guilty, or no contest to a felony? * Are you required by law to register as a sex offender? * Release of Information for Applicant * Authority for Release of Information
This release will constitute my/our consent and authority to examine statements and information regarding my/our background. I/We authorize you to contact my/our present and previous landlords, law enforcement agencies, credit agencies and other references listed above. I/We hearby authorize the release of any and all data or records to Hampton Management. This authorization is given connection with a financial, criminal and previous rental history investigation being conducted relative to my/our application for credit dealing with rental property. I/We acknowledge that my/our application fee will not be refunded if the landlord does not accept this application.
Applicant represents that statements made above are true and correct and hearty authorizes verification of references and credit report. Applicant understands that the above apartment is being held for the application, and if the apartment is not taken, the deposit will be applied to reimburse Hampton Management for any losses to include lost rent. Applicant agrees that the lease is contingent upon Landlord receiving a favorable credit and references report. Applicant agrees to execute and to be bound by lease agreement attached hereto and all provisions thereof. I/We operate in accordance with the Fair Housing Law. I/We do not discriminate against any person in the terms, conditions, or privileges of sale or rental of a swelling or in the provisions of services or facilities in connection therewith, because of race, color, religion, sex, familial status, handicap, or national origin, status with respect to public assistance, and marital status. Criminal background checks will be required of all applicants. With applicant's signature, said applicant is authorizing the criminal background check by Hampton Management. Date *