RENTAL APPLICATION

(MUST BE FILLED OUT COMPLETELY IN ORDER TO BE PROCESSED)

Property Address:		Rent: $ (First, Last & Deposit Required)	Date Available:
Applicant Last Name	First	Middle	Birth Date
Driver’s License # and State		Social Security #

RESIDENCE HISTORY

Present Address City State Zip	How Long? ____ Yrs ____ Mo	[ ] Own [ ] Rent	Phone ( )	Monthly Payment $
Name of Present Landlord	City State	Zip	Landlord Day Phone ( )	Night Phone ( )
Previous Address City State Zip	How Long? ____ Yrs ____ Mo	[ ] Own [ ] Rent	Phone ( )	Monthly Payment $
Name of Previous Landlord	City State	Zip	Landlord Day Phone ( )	Night Phone ( )
Previous Address City State Zip	How Long? ____ Yrs ____ Mo	[ ] Own [ ] Rent	Phone ( )	Monthly Payment $
Name of Previous Landlord	City State	Zip	Landlord Day Phone ( )	Night Phone ( )

EMPLOYMENT HISTORY/INCOME INFORMATION

Applicant Employed By	Department		Supervisor’s Name		How Long? _____ Yrs _____ Mo
Address City State Zip		Phone ( )		Position Held/Occupation	Monthly Salary $
Applicant Previous Employment		Department		Supervisor’s Name	How Long? _____ Yrs _____ Mo
Address City State Zip		Phone ( )		Position Held/Occupation	Monthly Salary $
Additional income: (child support, alimony or separate maintenance need not be disclosed unless such additional income is to be included for qualification hereunder.) Amount: $________________________ per __________________________ Source _________________________

FINANCIAL INFORMATION

Liabilities/Creditors (Auto Payment, Charge Cards, Child Support, Etc.)	Total Owed	Monthly Payments	Liquid Assets (Cash, Bank Accounts, Stock, Etc.)	Balance Value
1.	$	$		$
2.	$	$		$
3.	$	$		$
4.	$	$		$
PLEASE LIST ANY ADDITIONAL ASSETS OR LIABILITIES ON THE BACK OF THIS FORM:

OTHER IMPORTANT INFORMATION

Auto #1		Make & Model		License Plate # and State
Auto #2		Make & Model		License Plate # and State
Other Vehicles (Boats, Vans, Motorcycles, R.V’s, etc.) Make Model and License Plate #
Applicant’s Nearest Relative	Relationship		Address City State Zip		Phone ( )
Emergency Contact	Relationship		Address City State Zip		Phone ( )
Personal Reference	Relationship		Address City State Zip		Phone ( )

Have you ever: Been evicted? _______ Refused to pay rent? _______ Filed for bankruptcy? _______ Convicted of a felony? ________

Do you smoke tobacco? _______ If yes, are you willing to exclusively smoke outdoors? ________ Are you vegetarian? _____________

Do you have any pets? ________Type?_______________ Do you have a waterbed? _______ Do you plan on having a telephone? ______

Do you wish to paint, change window coverings, carpets or make any other alterations to the apartment? ____________________________

How long do you believe you’ll stay here? ___________________________ Why are you moving? ________________________________

Are your parents providing financial support or co-signing the lease? ______ If so, what is their occupation? _________________________

List all other persons to occupy the unit ________________________________________________________________________________

Screening Disclosure Notice

You are being charged a Non-Refundable fee of $ 25 for screening your application. Screening includes calling your employers, references, current and former landlords, financial institutions, a credit report, checking public records and verifying information on the application. If you are denied tenancy based on information reported, you have the right to dispute it by contacting the Owner/Agent. By signing this application you authorize the screening process and acknowledge a copy of this notice.

CORRECT INFORMATION - Applicants represent that all of the above statements are true and complete. Applicants acknowledge that giving false or incomplete information herein may constitute grounds for rejection of this application, termination of right of occupancy, and or forfeiture of deposits and may constitute a criminal offense under the laws of Washington State. Applicants understand they acquire no rights in the rental unit until a Holding or Security Deposit is paid when requested by the Owner/Agent.

If applicant has insufficient housing references, a co-signer may be required.

Applicant _______________________________________________________ Date ______________________

Revised 7/99