RENTAL APPLICATION

Desired Date of Occupancy: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , Year 2004 2005 2006

Personal Information: Applicant's First Name:  Applicant's Last Name: Driver's License #: Date of Birth (for credit reporting only): Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , Year 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

Other Resident #1 Full Name:   DL#: Age: Relation:   Other Resident #2 Full Name:   DL#: Age: Relation: Other Resident #3 Full Name:   DL#: Age: Relation: Other Resident #4 Full Name:   DL#: Age: Relation: Pets?: No  Yes  If Yes, what kind?: How many?: Does anyone that will be living here smoke? No  Yes Other Remarks:

RESIDENCE HISTORY PRESENT ADDRESS: Street: City State: Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP: Present Telephone: Length of time @ present address: Present Landlord or Mortgage holder/phone: Amount of Rent: $ Reason for Moving:

PREVIOUS ADDRESS: Street: City: State: Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP: Previous Telephone: Length of time @ previous address: Previous Landlord or Mortgage holder/phone: Amount of Rent: $ Reason for Moving:

APPLICANT EMPLOYMENT INFORMATION: EMPLOYED BY:How Long: Employer Address: Telephone: Position Held:    Supervisor: Social Security No: Gross Income per month: $

CO-RESIDENTS’ EMPLOYMENT INFORMATION: EMPLOYED BY:How Long: Employer Address: Telephone: Position Held: Supervisor: Social Security No: Gross Income per month: $

If you are applying for a lease with option to buy, please indicate the amount of money that you can put down towards the option/purchase ?$

BANKING AND CREDIT REFERENCES BANK #1:   BRANCH: Checking Account #: Savings Account #: BANK #2:   BRANCH: Checking Account #: Savings Account #:

CREDIT REFERENCE #1: Account #: Address: CREDIT REFERENCE #2: Account #: Address:

OTHER INFORMATION Number of automobiles (Including Company Cars): Make:  Year: Color: Tag #: State: Make:  Year: Color: Tag #: State: Make:  Year: Color: Tag #: State: Have you ever or do you plan on filing for bankruptcy? No Yes Explain: Do you currently have any outstanding judgments? No Yes If Yes, Please explain: Check if you have any of the following skills: Carpenter    Electrical         Air Conditioning Painting      Furnace Repair  Plumber  In Case of an emergency Notify: Full Name:   Relationship: Address: Telephone: