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RENTAL APPLICATION Please provide all of the information requested below. Incomplete information can delay the processing of your application PLEASE PRINT CLEARLY.

…………………………………………………………………………………………………………….............................. OCCUPANT(S) Name________________________________________

Co-Applicant __________________________________

SS#_____________________DL#_________________

SS#_____________________ DL# ________________

Date of Birth __________________________________

Date of Birth __________________________________

Phone: Home (_____)__________________________

Phone: Home (_____)__________________________

Work (_____)__________________________ E-mail Address ________________________________

Work

(_____)_________________________

E-mail Address_________________________________

Any other occupants (Name, Age, Relationship) NAME

AGE

RELATIONSHIP

NAME

AGE

RELATIONSHIP

_____________________________________________________

______________________________________________________

_____________________________________________________

______________________________________________________

_____________________________________________________

______________________________________________________

……………………………………………………………………………………………………………………………………………………….

EMPLOYMENT HISTORY Current Employer _____________________________

Co-Applicant Employer__________________________

Address _____________________________________

Address ______________________________________

City, State, Zip _______________________________

City, State, Zip_________________________________

Phone (_____)_______________________________

Phone (_____)________________________________

Supervisor __________________________________

Supervisor ____________________________________

Position

___________________________________

Position _____________________________________

How long_____________ Salary ________________

How long_______________ Salary _______________

……………………………………………………………………………………………………………………………… RENTAL HISTORY (No Less Than Two Years) Present Address _______________________________________________________________________________ Rent __________ Own __________ Rental/Mortgage Amount Paid Monthly _____________________________ Reason for leaving _____________________________________________________________________________ Landlord Name/Mortgage Co. ________________________________ Phone (_____)_______________________ Previous Address ______________________________________________________________________________ Rent __________ Own __________ Rental/Mortgage Amount Paid Monthly _____________________________ Reason for leaving ____________________________________________________________________________ Landlord Name/Mortgage Co. _________________________________ Phone (_____)______________________


……………………………………………………………………………………………………………………………… BANKING REFERENCE Name __________________________________________________ Phone (_____)_________________________ Address _____________________________________________________________________________________ Account No. ________________________ Checking ___________ Savings _________ Balance _____________ ……………………………………………………………………………………………………………………………… PERSONAL REFERENCES Name ______________________________________

Name _______________________________________

Address ____________________________________

Address _____________________________________

City, State, Zip_______________________________

City, State, Zip ________________________________

_

Relationship _________________________________

Relationship __________________________________

Phone No.___________________________________ Phone No. ____________________________________ ………………………………………………………………………………………………………………………………. OTHER INFORMATION Pets (describe) ________________________________________________________________________________ Water-filled Furniture (describe) __________________________________________________________________ Vehicles/Boats to be parked on premises (make/model/year/license no.): __________________________________ _____________________________________________________________________________________________ In the past, have you been delinquent in paying rent or other financial obligations? If yes, please explain: ________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ In the past, have you failed to perform any obligation of a rental agreement or have you been a defendant in an eviction lawsuit? If yes, please explain: ____________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ The information on this application is true and correct to the best of my knowledge. I hereby authorize ________________

or its agents to verify the above information and obtain either a consumer or investigative credit report, criminal background report and eviction records from E-Renter USA Ltd. I understand that the $___________________ fee for verifying this rental application is not a deposit, will not be applied to any rent, or refunded even if the application to rent is declined. ALL APPLICANTS MUST SIGN BELOW: SIGNATURE: ____________________________________________________ DATE ______________________ SIGNATURE: ____________________________________________________ DATE ______________________ ……………………………………………………………………………………………………………………………… FOR OFFICE USE ONLY NOTE: advise the applicant to authorize employers, bank, and landlords to release all relevant information to E-Renter USA Ltd

Remarks:____________________________________________________________________________________ ____________________________________________________________________________________________ Move in Date______________ Unit _____________ Unit Type_______________ Rent $ ___________________

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