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RENTAL APPLICATION FORM
Required for Application to Rent



Please fill out the secure form completely before submitting. Fields with an *asterisk are mandatory.
A $30.00 fee will be charged to process the application.
Each applicant will receive an email from DocuSign. This email will contain a link that will take the you to the
DocuSign site, and guide you through the process of signing the application.
You will be taken to PayPal upon submission of this form to remit payment.
Note: Smoking and Pets are NOT allowed.

Unit Number Applying For:

APPLICANT #1
*Name:    Suffix:
Any other name(s) used:
*SSN:   *DOB:   Drivers Lic. #:

  *Email Address:
*Please provide the best phone number where we can reach you:

APPLICANT #2
Process Applicant #2 as:
Name:    Suffix:
Any other name(s) used:
SSN:   DOB:   Drivers Lic. #:

   Email Address:

   Phone:


ADDRESS HISTORY
*Current Address:   *City:

*State:   *Zip:   *Landlord's Name:    *Phone:
*Own or Rent?    *Move in date:    *Notice given:


*Previous Address:   *City:

*State:   *Zip:   *Landlord's Name:    *Phone:
*Own or Rent?    *Move in date:    *Move out date:


EMPLOYMENT HISTORY
(Note: Income cannot exceed $48,650 for 1 person; $55,600 for 2 persons;
$62,550 for 3 persons; $69,500 for 4 persons)
*Applicant #1 Employer:
*Address:   *City: *State:   *Zip:
*Work Phone:
*Position   *Hire Date:   *Annual Salary: $


Applicant #2 Employer:
Address:   City: State:   Zip:
Work Phone:
Position   Hire Date:   Annual Salary: $


BANKING INFORMATION
Checking Account:
Bank's Name:   Account Number:
Savings Account:
Bank's Name:   Account Number:


PERSONAL REFERENCES
*1) Name & Address

Phone:   Years Known:

2) Name & Address

Phone:   Years Known:

3) Name & Address

Phone:   Years Known:


ADDITIONAL OCCUPANTS
1) Full Name    Date of Birth:

2) Full Name    Date of Birth:

3) Full Name    Date of Birth:


ADDITIONAL INFORMATION
*Have you ever been a party to an eviction?
*Have you ever filed Bankruptcy?
*Have you ever been convicted of a Crime?


FORM SUBMISSION
BY CLICKING THE SUBMIT BUTTON BELOW, I / WE DECLARE THAT ALL INFORMATION GIVEN IN THIS APPLICATION IS TRUE AND CORRECT. WE AUTHORIZE 19TH & I INVESTMENT GROUP, LLC TO VERIFY AND OBTAIN A CREDIT REPORT, VERIFY LANDLORDS, EMPLOYMENT AND CRIMINAL REPORTS.