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APPLICATION TO RENT DATE: _____________, 20______, at ____________________________________________________, California. THIS CREDIT APPLICATION is for payment of monthly rent in the amount of $_______________. Property address: ______________________________________________________________________________ Received from Applicant(s) $_______________, cash, or check, for a consumer credit report which is a non-refundable cost and not a deposit. Received from Applicant(s) $_______________, cash, or check, as a deposit toward the first month’s rent on Landlord’s acceptance of the applicant's creditworthiness. Applicant(s) : Applicant One __________________________________________________________________________________ (Last Name) (First Name) (Middle Name) (Sr., Jr., etc.) Social Sec. # ________________________________ Drivers Lic. # _________________________ State___ Phone ________________ Cell _________________ Email _________________________________________ Applicant Two __________________________________________________________________________________ (Last Name) (First Name) (Middle Name) (Sr., Jr., etc.) Social Sec. # ________________________________ Drivers Lic. # _________________________ State___ Phone ________________ Cell _________________ Email _________________________________________ Additional Occupant(s): Name ___________________________________________________________________ Name ___________________________________________________________________ Rental History: Have you ever been party to an eviction? Yes No Filed bankruptcy? Yes No Present Address ________________________________________________________________________________ City ____________________________________________________________ Zip _______________________ Length of Residency _____________ Monthly Rent $_______________ Landlord/Agent ____________________________________________________________ DRE # __________ Address ____________________________________________________________________________________ Phone ________________ Cell _________________ Email ________________________________________ Reason for Moving _________________________________________________ Moving Date ____/____/____ Previous Address _______________________________________________________________________________ City ____________________________________________________________ Zip _______________________ Length of Residence _____________ Monthly Rent $_____________ Landlord/Agent ____________________________________________________________ DRE # __________ Address ____________________________________________________________________________________ Phone ________________ Cell _________________ Email _______________________________________ Employment: Applicant One Employer __________________________________________________________________________________ Address ___________________________________________________________________________________ Phone ________________ Cell __________________ Email _______________________________________ Length of Employment _____________ Position ________________________________ Wages ___________ Pay Period ____________________ Union _______________________________________________________ Previous Employer ___________________________________________________________________________ Address ____________________________________________________________________________________ Phone ________________ Cell __________________ Email _______________________________________ Applicant Two Employer ___________________________________________________________________________________ Address ____________________________________________________________________________________ Phone ________________ Cell _________________ Email _______________________________________ Length of Employment _____________ Position ___________________________ Wages _________________ Pay Period ____________________ Union ______________________________________________________ Previous Employer ___________________________________________________________________________ Address ____________________________________________________________________________________ Phone _________________ Cell __________________ Email _______________________________________ Additional Income Amount $_____________ Source __________________________________________________ Recipient ______________________________________________________________________________________ General Credit Information: Automobile One: Make __________________________________________________________________________ Year _____________ Model ____________________ Lic. #/State ____________________________________ Lender _____________________________________________________________________________________ Automobile Two: Make___________________________________________________________________________ Year _____________ Model ____________________ Lic. #/State ____________________________________ Lender _____________________________________________________________________________________ Bank/branch ___________________________________________________________________________________ Check Acc. # _______________________________________ Savings Acc. # __________________________ Bank/branch ___________________________________________________________________________________ Check Acc. # ______________________________________ Savings Acc. # __________________________ Credit References: 1. ________________________________________________________________________________________ Address ____________________________________________________________________________________ Account # ______________________________ Balance due $_______________ Phone __________________ 2. ________________________________________________________________________________________ Address ____________________________________________________________________________________ Account # ______________________________ Balance due $_______________ Phone __________________ Personal Reference ________________________________________________________________________________________________ Address __________________________________________________________________________________ Phone _________________ Cell ____________________ Email ___________________________________ Personal Reference ________________________________________________________________________________________________ Address ___________________________________________________________________________________ Phone _________________ Cell ____________________ Email ___________________________________ Nearest Relative (name/relationship) _______________________________________________________________________________ Address ___________________________________________________________________________________ Phone _________________ Cell ____________________ Email ___________________________________ Emergency Contact (name/relationship) ____________________________________________________________________________ Address ___________________________________________________________________________________ Phone _________________ Cell ____________________ Email ___________________________________ I/We declare all information given in this application is true and correct. I/We authorize your credit reporting agency to obtain and verify a complete consumer report and supply the information obtained to you. This information is not privileged. Date: _____________, 20______ Name: ____________________________________________ Signature: __________________________________________ (Applicant 1) Name: ____________________________________________ Signature: __________________________________________ (Applicant 2) I acknowledge receipt of this credit application and
FORM 553 03-11 © 2011 first tuesday , P.O. Box 20069, RIVERSIDE, CA 92516 (800) 794-0494 |