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ONE APPLICATION FOR EACH ADULT APPLICANT (18 YEARS OF AGE OR OLDER). You will be denied rental if you misrepresent any information on this application. If misrepresentations are found after a rental agreement is signed, your rental agreement will be terminated. Proof of identification is required.

MB Properties Rental Application

Mail to:825 West Howard Street, Winona, Mn. 55987 4 or fax to: 507-494-6503 5 or email to jmendell@hbci.com 3

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Date: __________________

Information on Rental Unit being applied for

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Address:_____________________________________________

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Monthly Rental Amount: _________________________________

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Lease Terms: _________________________________________

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Utilities Included: ______________________________________

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Unit No. # __________________ Security Deposit Amount: _______________________

Personal Information

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Applicant's Full Name: ____________________________________________________________

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Address ________________________________________________________________________ Soc. Sec. No.: ______________

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City, State, Zip __________________________________________________________________

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Driver's License No. ____________________________________________ Other Phone: _______________ Type: (cell/work/other)

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(Name) OTHER RESIDENTS (Relationship)

DATE OF BIRTH

Date of Birth: _______________

Home Phone: _______________

SOC. SEC. No.

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__________________________________________________________________________________________________________

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__________________________________________________________________________________________________________

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__________________________________________________________________________________________________________

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Rental History

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Current Address:_________________________________________________________________ How Long? ________________

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Current Landlord _________________________________________________________________ Phone ____________________

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Why are you moving? ____________________________________________________________

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Current Rent Amount ________

(COMPLETE IF LESS THAN ONE YEAR AT PRESENT ADDRESS)

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Previous Address ________________________________________________________________ How Long? ________________

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Previous Landlord ________________________________________________________________ Phone ____________________

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Reason for Moving? ______________________________________________________________ Current Rent Amount ________

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Have you ever broken a Lease? _________ How many evictions have been filed on you? __________ Are you a convicted Felon? ____

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Employment History

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Current Employer ________________________________________________________________ Starting Date _______________

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Address ________________________________________________________________________

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Job Title ________________________________________________________________________ Gross Monthly Income _______

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Supervisor ______________________________________________________________________ Phone _____________________

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Other Employment, Employer ______________________________________________________

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Address ________________________________________________________________________

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Job Title ________________________________________________________________________ Gross Monthly Income _______

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Supervisor ______________________________________________________________________ Phone _____________________

Starting Date _______________


OTHER SOURCES OF INCOME

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Sources of other income and average monthly amounts:_____________________________________________________________

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__________________________________________________________________________________________________________

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How much cash do you have? __________________________

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What may interrupt your income or ability to pay rent?_______________________________________________________________

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__________________________________________________________________________________________________________

Do you own Real Estate? _________________________________

CREDIT & FINANCIAL INFORMATION

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Do you have a checking account? Yes / No

Name and City of Bank/Credit Union ____________________________________

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Do you have a savings account? Yes / No

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Credit References (auto loans, personal loans, credit cards)

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Type _______________________________ Name of Creditor ____________________________

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Total Amount Owed ___________________________________ Monthly Payment Amount: _______________________________

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Type _______________________________ Name of Creditor ____________________________

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Total Amount Owed ___________________________________ Monthly Payment Amount: _______________________________

Name and City of Bank/Credit Union ____________________________________

OTHER INFORMATION

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Automobiles and Other Vehicles

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Make and Type______________________________ Year ____________

Color ____________ License No. ________________

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Make and Type______________________________ Year ____________

Color ____________ License No. ________________

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Make and Type______________________________ Year ____________

Color ____________ License No. ________________

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What kind of animals do you have? _________________________________________________

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In case of personal emergency, notify:

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Name ______________________________________________ Phone _____________________ Relationship ________________

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Address ___________________________________________________________________________________________________

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Name ______________________________________________ Phone _____________________ Relationship ________________

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Address ___________________________________________________________________________________________________

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I hereby apply for rental of premises described as: _________________________________________________________________

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______________________________________________________________________ Date Required _______________________

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Term of Rental ______________________________________, __________ to _____________________, _____________

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Monthly Rental $ ______________________________ Security Deposit $ ______________________________________

Do you own furniture? ________

69 I enclose the sum of $___________________ (not to exceed $20) which is a non-refundable fee for a Consumer Credit Report. 70 Tenant may request in writing within seven days after delivery of the rental unit a list of physical damages or defects, if any, charged 71 to the previous tenant's security deposit. 72 I enclose herewith $ ______________________, which will be forfeited, as provided by law, if you accept this application, and I do 73 not take the __________________________. Said deposit to be returned to me if this application is not accepted. Said deposit to 74 apply on the first month's rent if consummated. I hereby certify that all statements made above are correct. 75 NOTICE: You may obtain information about sex offender registry and persons registered with the registry by contacting the 76 Wisconsin Department of Corrections on the Internet at http://www.widocoffenders.org or by phone at 877-234-0085 77 I certify that all of the information provided in this application is true and 78 accurate to the best of my knowledge and that my rental agreement may

Applicant, once approved, must obtain renter’s insurance and Landlord will attempt to contact the Applicant by the phone numbers listed on this application.

79 be terminated if I have made any false, misleading or incomplete statements 80 in this application. I authorize verification of the information provided in this 81 application from my credit sources, current and prior landlords, employers

My rental of said premises is to be limited to use and occupancy by family of size and description above without any right on my part to sublet all or any of said premises.

82 and personal references. 83 I acknowledge being furnished copies of the Rental Agreement, Rules & 84 Regulations, and if applicable, any Nonstandard Rental Provisions. I agree to 85

I authorize you to contact any references that I have listed, before, during or after my tenancy.

sign the completed Rental Agreement, Rules & Regulations and Nonstandard

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Rental Provisions, if applicable, prior to taking occupancy of the unit.

84 NOTE: A SECURITY DEPOSIT IS REQUIRED FROM EVERY 85 TENANT AGAINST DAMAGE OR LOSS TO THE PREMISES, AND 86 SAID SECURITY DEPOSIT CANNOT BE USED FOR THE LAST 87 MONTH'S RENT.

_____________________________________________ Signature of Applicant Date Please Note: Landlord is using public records provided by a third party service to determine your eligibility to rent. Neither Landlord, nor the third party service, can vouch for the accuracy of the records as they have no control over such records. It is the responsibility of the applicant to check the accuracy of their own public records.

Rental Application MB Properties  

Application for prospective tenants to fill out

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