Applicant

First Name

Middle Initial

Last Name

Social Security Number

Date of Birth

U.S. Citizen?

 Yes No

if No, Please explain if you have a Consular Card, or Passport of what country?

Home Phone

Cell Phone

Work Phone

 Click here if ok to call work

Email Address

Present Address

Current Landlord Name

Street Address

City

State

Zip Code

Current Landlord Contact Number

Rent or Own?

 

Have you ever had an eviction or an Unlawful Detainer filed against you?

 Yes No

If Yes, we are unable to proceed.

How is your credit in the last 12 months? (Check one)

 Good Fair Poor

If Poor (more than a few delinquencies in the last 12 months (we are unable to proceed - Medical delinquencies are exempt).

Reason for leasing present address?

Please explain the issue we may find on your credit

Present Employer

Name

Street Address

City

State

Zip Code

Active?

Retired?

Employment Length

Position

Phone Number

Applicant Income

Wages $

Interest / Dividend $

Net Rental $

Distributions $

Pension / SS Income

Other $

Total

Co-Applicant

First Name

Middle Initial

Last Name

Social Security Number

Date of Birth

U.S. Citizen?

 Yes No

if No, Please explain if you have a Consular Card, or Passport of what country?

Home Phone

Cell Phone

Email Address

Co-Applicant Present Address

Street Address

City

State

Zip Code

Rent or Own?

Reason for leasing present address?

Income Co-Applicant

Wages $

Interest / Dividend $

Net Rental $

Distributions $

Pension / SS Income

Other $

Total

References we can call

Last Name

First Name

Current Address

Street Address

City

State

Zip Code

Phone

Email Address

Relation:  Parent Relative Friend

Best person to contact you with a decision on your application?

Last Name

First Name

Phone

Email Address

Relation:  Parent Relative Friend

Check this box Providing The Holstein Group/Holstein Properties authorization to run a credit report on Applicant and Co Applicant's behalf to be considered for an apartment rental.

Should your application be denied, The Holstein Group/Holstein Properties is NOT allow to send your credit report or discuss it.. However you have the right to contact the credit bureaus directly at

1.888.333.2413 (CoreLogic/SafeRent/Experian) to dispute and or obtain a copy.

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