RentalApplication

Theundersignedherebymakesanapplicationtorentunit#32locatedat:SunsetAvenue.

Anticipatedmovedateof6/29/19atamonthlyrentof$730andsecuritydepositof$100.

PLEASETELLUSABOUTYOURSELF
FullName
ErinGansemer

HomePhone
(555)4987291

DateofBirth
June29,2000 SocialSecurity#(FAKE)
526819420
EmailAddress
nsstudent@gmail.com
OtherPhone
(555)6732323
CoApplicantName_______________________________________

CoApplicantDateofBirth____________ SocialSecurity#(FAKE)__________________
NamesofDependents__________________________________________________
DependentsDatesofBirth_________________________________________________
ListAllPets
Zoey(MalteseShitzu),
PLEASEGIVERESIDENTIALHISTORY(LAST3YEARS)
CurrentAddress
609N7thStreet

Apt#___________

City
Eldridge State
Iowa
ZipCode
52748
Month/YearMovedIn
June/2000
Rent$
None
ReasonsforLeaving
GoingtoCollege
Owner/Agent
DarWalden
Phone
(555)7983347
PLEASEPROVIDEYOURCREDITHISTORY
Haveyoudeclaredbankruptcyinthepast7years?

Yes/
No

Haveyoueverbeenevictedfromarentalresidence?

Yes/
No

Haveyouhadtwoormorelaterentalpaymentsinthepastyear? Yes/
No
Haveyoueverwillfullyorintentionallyrefusedtopayrentwhendue?

Yes/
No

PLEASEPROVIDEYOUREMPLOYMENTINFORMATION
YourStatus

FullTime_____PartTime
YES
Student
YES
Unemployed_____

Employer
Sips
DatesEmployed
January27,2014 Employedas
SupervisorName
NancySmith
Phone
(555)4388401
Salary$
12
per
hour
Ifemployedbyabovelessthan12months,givenameandphoneofpreviousemployeror
school______________________________________________________________________


Ifyouhaveothersourcesofincomethatyouwouldlikeustoconsider,pleaselistincome,
source,andperson(banker,employer,etc.)whowemaycontactforconfirmation.Youdonot
havetorevealalimony,childsupport,orspousesannualincomeunlessyouwantusto
consideritinthisapplication.
Amount$________________

Source/Contact______________________________

PLEASELISTYOURREFERENCES

RentalApplicationcontinued
BankingAccounts
Name
ErinGansemer
AccountType
Checking
Account#
42952
Name___________________AccountType_________________Account#_________

PersonalReferenceorEmergencyContact
Name
ToddGansemer
Address
609North7thStreet,Eldridge,Iowa52748
Phone
(555)4987291
Relationship
Dad

DriversLicense
License#
4H85L284
State
Iowa

VehicleInformation
Make/Model
Toyota/Camry
Year
2005
LicensePlate
XBS923
State
Iowa

ADDITIONALINFORMATIONPleasegiveanyadditionalinformationthatmighthelp
owner/managementevaluatethisapplication.
____________________________________________________________________________
____________________________________________________________________________
__________________________________________________________


Wheremaywereachyoutodiscussthisapplication?
DayPhone
(555)2351789 NightPhone
(555)2351789
Iherebyapplytoleasetheabovedescribedpremisesforthetermanduponthesetconditions
abovesetforthandagreethattherentalistobepayablethefirstdayofeachmonthinadvance.
Asaninducementtotheownerofthepropertyandtotheagenttoacceptthisapplication,I
warrantthatallstatementsabovesetfortharetruehowever,shouldanystatementmadeabove
beamisrepresentationornotatruestatementoffacts,allofthedepositwillberetainedto
offsettheagentscost,time,andeffortinprocessingmyapplication.
Iherebydeposit$
100
asearnestmoneytoberefundedtomeifthisapplicationisnotaccepted
in3businessbankingdays.Uponacceptance,thisdepositshallberetainedaspartofthe
securitydeposit.Whensoapprovedandaccepted,Iagreetoexecutealeasefor
6
months
beforepossessionisgivenandtopaythebalanceofthesecuritydepositpriortothemovein
date.Iftheapplicationisnotapprovedoracceptedbytheowneroragent,thedepositwillbe
refunded,theapplicantherebywaivinganyclaimfordamagesbyreasonofnonacceptance.I
recognizethatasapartofyourprocedureforprocessingmyapplication,aninvestigative
consumerreportmaybepreparedwherebyinformationisobtainedthroughpersonalinterviews
withotherswithwhomImaybeacquainted.Thisinquiryincludesinformationastomy
character,generalreputation,personalcharacteristics,andmodeofliving.
Theaboveinformation,tothebestofmyknowledge,istrueandcorrect.

ApplicantSignature
Erin

Gansemer

Date
April,262016