RENTAL APPLICATION

Name *

First

Last

Phone *

Email *

SSN# *

DOB (Date of Birth) *

Current Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Rental Amount

How long have you lived there?

Reason for leaving: *

Was current rental subsidized?

Yes
No

If yes, please provide client ID#

Current Landlord Name:

First

Last

Current Landlord Phone:

Previous Address:

Address Line 1

Address Line 2

City

State

Zip Code

Previous Rental Amount

How long have you lived there? (Previous address)

Was previous rental subsidized?

Yes
No

Previous Landlord Name:

First

Last

Previous Landlord Phone:

Have you ever been evicted, sued for nonpayment of rent, utilities or breached a lease (if so, explain)? *

Full names of all individuals and ages of all who will be occupying the property: *

Pets? (specify)

Employment

Current Employer:

Current Employer Phone

Current Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Occupation:

Title:

Gross Monthly Salary: *

How long employed here? *

Previous Employer:

Previous Employer Phone

Previous Employer Address

Address Line 1

Address Line 2

City

State

Zip Code

Occupation:

Title:

Gross Monthly Salary: *

How long employed here? *

Banking Info

Savings/Checking account bank name:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Account balance:

Approximate Balance:

Additional Info

Driver License Number:

Issuing State:

Year/Make/Model of vehicle:

License Plate #:

State:

Reference & Emergency Contact

Personal Reference:

Phone

Reference Address:

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact:

Emergency Contact Address:

Address Line 1

Address Line 2

City

State

Zip Code

Relationship:

Phone

I certify that the above information is true and complete. I authorize the verification of this information by the contacting any or all individuals and financial institutions listed above. I understand that this is not a lease or an offer to rent. No binding obligation of any kind exist between the owner and myself unless and until a lease is signed. This application is subject to prior applications. This application shall remain the property of the owner. *

I Agree

Signature of Applicant:

Date / Time

Email us at : admin@ballardpropertiesllc.com

ballardpropertiesllc.com

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