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APPLICATION FOR RENTAL-ADDRESS Residents Name & Soc. Sec. Number of all adults to reside in unit: Name/relationship/Age/Soc.Sec.Number of all to live with you:   Current Living Status Present Address City State Zip Code Current Phone Current Rent Amount Reason for moving: Length of time at present address Owner/Manager Phone   Previous Living Status Previous Address City State Zip Code Previous Phone Previous Rent Amount Reason for moving: Length of time at previous address Owner/Manager Phone   Employment Info Employer's name/address/tele number: Current monthly income after deductions Years at Job List other sources of income:   Bank Info Bank Name Branch Acct Number Type   Credit Institution Info Credit Reference Phone Your Credit Info Acct Number Balance Payment   Misc Info Have you ever filed for bankruptcy? Yes No If yes, when Have you ever been evicted? Yes No Waterbed? Yes No Pets? Yes No Describe Name/address/tele number of nearest relative of nearest relative: Motor vehicles to be parked on premises make/model/yr/tag no.: Comments: Your email address   I declare that the statements above are true and correct, and I Hereby authorize verification of references given and a credit check. Signature Date Signature Date