Rental Application — Carolina Díaz Realtor

Personal information

Full name *

Date of birth *

SSN *

Phone *

Email *

Current address

Street address *

City *

State *

ZIP code *

Owned / Rented *

Monthly payment ($) *

How long? (months) *

Previous address

Street address *

City *

State *

ZIP code *

Owned / Rented *

Monthly payment ($) *

How long? (months) *

Are you married? If yes, co-applicant information will be required

Applicant — employment information

Current employer *

Employer address *

City *

State *

ZIP code *

Phone *

Email *

Position *

Hourly / Salary *

Annual income ($) *

How long at this job? *

Emergency contact

Name (not residing with you) *

Address *

City *

State *

ZIP code *

Phone *

Relationship *

Email *

References

Reference name *

Address *

Phone *

Reference name

Address

Phone

Do you have pets? Maximum of 3 pets allowed

Other information

Have you ever had an eviction filed or left owing money to an owner or landlord?

No Yes

Have you ever submitted a rental application but then did not move in?

No Yes

Have you ever had adjudication withheld or been convicted of a crime?

No Yes

If yes to any of the above, please explain

Authorization of release of information. Applicant (and spouse) represents that all of the above information is true and complete, and hereby authorizes an investigative consumer report including, but not limited to, residential history, employment history, criminal history, court records, and credit records. This application must be signed before it can be processed. Applicant acknowledges that false or omitted information may constitute grounds for rejection of this application, termination of right of occupancy, and/or forfeiture of fees or deposits, and may constitute a criminal offense under the laws of the state.

Disclaimer. Avanti Way Realty LLC neither independently evaluates your application to lease, nor makes the ultimate decision regarding whether your application is approved or declined. Avanti Way Realty LLC uses the services of vendors to collect information from credit bureaus, check writing recovery services, public court records, and other databases, but does not independently collect, provide, or assemble any information used in evaluating your application. Avanti Way Realty LLC neither warrants nor guarantees the accuracy, sufficiency, or reliability of any information obtained.

Signature

Signature of applicant *

Date

Application received

Thank you. Your rental application has been submitted and will be reviewed by our team shortly. We will contact you via email or phone.

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