LEASE ATTACHMENT A

RENTAL APPLICATION

1. All information will be used for an investigative report of present and past sources to evaluate the financial ability and personal character of the applicant.

2. Inaccurate or missing information shall be cause for default of the Lease.

3. Each prospective Tenant must complete a seperate application.

4. A non-refundable $25 credit report fee must accompany this application.

Personal Information:

Full Name ____________________________________ Date of Birth ________________

Social Security # ______________ Driver's License # ________________ State _______

Home Phone # ______________________ Work Phone # ________________________

Residential Information:
(Complete for past three years. Use additional sheets as necessary)

Current Address _______________________________________ How long? _________

Reason for moving________________________________________________________

Landlord____________________________________ Phone #_____________________

Previous Address _____________________________________ How long? _________

Reason for moving________________________________________________________

Landlord____________________________________ Phone #_____________________

Previous Address _____________________________________ How long? _________

Reason for moving________________________________________________________

Landlord____________________________________ Phone #_____________________

Previous Address _____________________________________ How long? _________

Reason for moving________________________________________________________

Landlord____________________________________ Phone #_____________________

Employment Information:

Employer #1________________________________________ How long?____________

Address____________________________________ Phone # ____________________

Occupation________________________ Income__________________ Per __________

Supervisor__________________________________ Phone # ____________________

Employer #2________________________________________ How long?____________

Address____________________________________ Phone # ____________________

Occupation________________________ Income__________________ Per __________

Supervisor__________________________________ Phone # ____________________

Financial References:

Bank _________________________ Address _________________________________

Checking Acct # _____________________ Savings Acct # _______________________

Credit Reference ____________________________ Acct # ______________________

Address _______________________________________________________________

In Case of Personal Emergency:

Parent _____________________________________ Relationship_________________

Address____________________________________ Phone # ____________________

Nearest Relative _____________________________ Relationship _________________

Address ____________________________________ Phone # ____________________

Have you ever:

Filed bankrupcy? ________ If yes, explain _____________________________________

______________________________________________________________________

Been evicted? __________ If yes, explain _____________________________________

______________________________________________________________________

Refused to pay rent? _______ If yes, explain ___________________________________

______________________________________________________________________

Applicant warrants that information is accurate and complete and authorizes Landlord to obtain a credit report, which Landlord (or Collection Agency) may use to collect past due rent payments, late or other charges from Tenant, both during the term of the Lease and thereafter.

Signature _____________________________________________ Date _____________________