Leavenworth Rentals - Property Management

RENTAL APPLICATION

PERSONAL INFORMATION

First Name:
Last Name:
Street Address 1:
Street Address 2:
City:
State / Province:
Zip / Postal Code:
Home Phone Number:
Current Country of Residence:
Move-In Date:
Current Landlord's Name & Phone Number:
Previous Address:
Previous Landlord's Name & Phone Number:

EMPLOYMENT INFORMATION

Current Employer:
Employer's Address:
Job Title:
Length of Employment (years):
Work Phone:
Monthly Income:
Supervisor's Name & Phone Number:
Previous Employer:
Previous Employer's Address:
Previous Job Title:
Previous Length of Employment (years):
Previous Work Phone:
Previous Monthly Income:
Supervisor's Name & Phone Number:

SPOUSE OR ROOMMATE INFORMATION

Please Choose:	Spouse Roommate
Name:
Monthly Income:
Employer:
Employer Phone Number:

OTHER INFORMATION

Other Income To Be Considered:
List all other persons who will be occupying the apartment, but not signing the lease: (name and age)
List all vehicles to be parked on the premises: (vehicle type, make, year, license #)
Your e-mail address:
Do you have a Pet?	Yes No
How many pets do you have?
What type of pet(s) do you have? (i.e. cat, dog, etc)
Please list the Breed of Each Pet (with the SIZE and AGE of each pet in parenthesis). Example: Lab (medium; 5 years old)
Has applicant, co-applicant, or any occupant listed above ever:
Ever been evicted or asked to move out? Yes No Broken a rental agreement or lease contract? Yes No Declared bankrupcy? Yes No Been sued for non-payment of rent? Yes No Been sued for damages to a rental property? Yes No If any of the above answers are "yes", please explain: Why are you leaving your present residence?
In case of an emergency, notify: (name, relationship, phone #)
We accept check, money order, or cash. Check must be received within 7 days of this application in order to validate this lease. (Do not mail cash.) Mail your check to: Leavenworth Rentals, Inc. 619 Holiday Plaza Lansing, KS 66043

By submitting this application I certify that all the above statements are true and complete. Landlord is authorized to verify such information by consumer reports, rental history reports, criminal reports and other means, but is not required to make verifications or investigations. Failure to answer the above inquiries or false information given above shall entitle Landlord to reject this application, retain the application fee(s) and deposit(s) as liquidated damages for time and expenses of processing the application, and terminate resident's right of occupancy.

I agree to Rental Policies and Procedures

I agree to pay a fee of $35.00 to cover the cost of the credit report if any adverse information is obtained through our screening of the applicant's information or if there are any omittee areas on this application.

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