Date: December 16, 2017


Application is hereby made to rent premises generally described as 202 N West Ave Apt 4, Milford, Illinois 60953 for a term of 1 year and thereafter month to month tenancy and ending serving a 30 day written notice, for which monthly rental shall be $350 payable in advance, and for which a security deposit of $400 shall be due prior to occupancy of the above described premises. The information provided herein may be used by the landlord or his agent to determine whether to accept this application.

 

PRIMARY APPLICANT

Applicant's Full Name: Date of Birth:
Previous Name(s): Email:
Phone: Alt Phone:
Current Address: City, State Zip:
Landlord's Name: Landlord's Phone:
How Long: Reason for Leaving:
Previous Address: City, State Zip:
Landlord's Name: Landlord's Phone:
How Long: Reason for Leaving:

 

EMPLOYMENT

Present Employer: Position:
Monthly Income: How Long on Present Job:
Bus. Phone: Supervisor:
Employer Address: City, State Zip:
Other income/source: Monthly Income:

 

SECONDARY APPLICANT

Applicant's Full Name: Date of Birth:  
Previous Name(s): Email:
Phone: Alt Phone:
Current Address: City, State Zip:
Landlord's Name: Landlord's Phone:
How Long: Reason for Leaving:
Previous Address: City, State Zip:
Landlord's Name: Landlord's Phone:
How Long: Reason for Leaving:

 

EMPLOYMENT

Present Employer: Position:
Monthly Income: How Long on Present Job:
Bus. Phone: Supervisor:
Employer Address: City, State Zip:
Other income/source: Monthly Income:

 

OTHER

Service Pets Only
Children: How Many:   Ages:
Other Adults:   Relationship:
Have you ever been party to an eviction? Yes No

 

REFERENCES (No Relatives - First and Last Name)

Personal Reference:
Yrs. known: Relationship: Phone:
Personal Reference: Yrs. known: Relationship: Phone:
Personal Reference: Yrs. known: Relationship: Phone:

Credit Reference:
Phone:
Credit Reference: Phone:
Credit Reference: Phone:

 

Application will be sent to: scross@rentimc.com


By submitting this Application, you agree to authorize the landlord or his agent to conduct a background and/or credit check. Landlord may request more information.

 

 

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