Rental Application

What Address are you applying for?

First name

Last name

Social Security Number

Date of Birth

Day

Month

Year

Drivers License Number

Phone

Current Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

How Long have you been at this address?

If less than 3 years at current address list previous address or NA

How much rent do you pay at your current address?

Current Employer

Job Title

Current Employers Phone

How long have you worked here?

How much do you make per hour? or Annual Salary?

Any additional income? If yes, explain.

List the names, relationship to you, and ages of those who will occupy the residence.

What is your desired move in date?

Any Pets? List breeds of each or NA (additional deposit may be required)

Have you ever been evicted?

Yes

Ever refused to pay rent?

Yes

Ever broken a Lease?

Yes

Anything else you want the homeowner to know? or NA

I authorize the landlord or their agent to verify all information provided, including credit, criminal background, rental history, and employment. I understand that false information may result in denial of my application.

Completion of this application does not guarantee approval. All applicants are evaluated based on income, rental history, and background screening in compliance with fair housing laws

Signature

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Application submitted through

ICON Real Estate

A division of MelHar Properties LLC

Brandy L Browm, Broker.

Professional Leasing & Property Placement Services

Brandy Brown, Broker

Brandy Brown, Broker

Rental Application