Property Address:_______________________          Rent Amount:______________________

     Prospective Tenant Name:________________________    Phone:________________________

     Email Address:________________________________

 

 Desired Length of Occupancy________________    Desired Date of Occupancy___________________

Do you own a Waterbed?_______________                 Number  of Smokers in Household____________

I/WE HEREBY CERTIFY THAT THE ANSWERS WE HAVE GIVEN ON THIS APPLICATION ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.  I UNDERSTAND THAT ANY FALSE ANSWERS OR STATEMENTS MADE BY ME WILL BE SUFFICIENT GROUNDS FOR EVICTION AND LOSS OF ANY SECURITY DEPOSIT.  I UNDERSTAND THAT THE APPLICATION FEE ($45) IS NON REFUNDABLE AND THE APPLICATION DEPOSIT WILL BE APPLIED TOWARDS THE SECURITY DEPOSIT IF APPLICATION IS APPROVED. IT WILL BE FORFEITED IF APPLICATION IS APPROVED AND TENANT DOES NOT RENT THE HOUSE.  IT WILL BE REFUNDABLE IF APPLICATION IS NOT APPROVED. I AUTHORIZE VERIFICATION OF ANY INFORMATION SUPPLIED IN THIS APPLICATION BY LANDLORD OR AGENT TO IMPLEMENT OR ENFORCE THE CONDITIONS OF THE LEASE.

SIGNATURE_________________________________      SIGNATURE_______________________________________