Rental Application
Name (s) _______________________________________________ Desired length of occupancy ___________
Address, city, state, zip______________________________________________________________________
Home Phone ____________ Work ____________ Cell ____________ E-mail __________________________
Personal Access/Information: Date of birth: __________ Social Security #: ______________________________
Nearest relative not living with you: ________________________________ Phone # _____________________
Address, city, state, zip______________________________________________________________________
Number of Vehicles ___ Drivers License #/ state _______________Make/year/model ______________________
License plate #/state ___________________Color Legal Owner ____________________________
Rental Party and History: Number in family/group ______ Ages/names _________________________________
__________________________________________________________________________________________
Pets? Number and type_______________________________________________________________________
Current Landlord name _____________________________________ Phone # __________________________
How long at this address? _________ Current rent __________ Reason for moving ______________________
Employment References: Work or Business name: _______________________________________________
Phone # ___________________Position or description: ____________________________________________
How long at this job? _________________________ How long at previous job? _________________________
Monthly income: __________ Other income? ____________ Describe ________________________________
Financial References:
Bank Account/Branch ____________________________________________ Phone # ____________________
Account # ________________________________________________ Current balance ___________________
Bank Account/Branch ____________________________________________ Phone # ____________________
Account # ________________________________________________ Current balance ___________________
Credit Account Name ____________________________________________ Phone # ____________________
Account # ________________________________________________ Current balance ___________________
Credit Account Name ____________________________________________ Phone # ____________________
Account # ________________________________________________ Current balance ___________________
Personal References: Name ______________________________________ Phone # ____________________
Name ______________________________________ Phone # ____________________
Tell us a bit about yourself:
Application can be e-mailed as a Word Document or PDF file to valiofmoon@gmail.com. Applications will be processed in the order received, verified, and forwarded for neighbor review. Applicant represents that all statements above are true and authorizes Dan Viele Associates to verify all information and references. We can be reached by phone at our office once we have pre-screened your application.
Signature of Applicant(s) __________________________________________ Date ______________________
Signature of Applicant(s) __________________________________________ Date ______________________
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