Brooks and Broadwell Realty
Rental Application
(Neatly complete all information below. All applicants over the age of 18 must complete and sign their own application.)
Applicants full name___________________________________DOB______________SS#__________________
Drivers Lic. # ___________________ Phone # ____________________ Cell # ________________________
Employer: _________________________________________ Employer Phone # _________________________
How long employed: ________________
Co-applicants full name______________________________________DOB______________SS#_____________
Drivers Lic. # ____________________ Phone # ___________________ Cell # ___________________________
Employer: _________________________________________ Employer Phone # _________________________
How long employed: ________________ Relationship to applicant _____________________________________
Current Address________________________________City___________________State________Zip_________
Current Landlords Name__________________________________Landlords Phone #______________________
Previous Address________________________________City___________________State_______Zip_________
Previous Landlords Name__________________________________________Phone #______________________
Do you have pets? __________ Type: ____________ How long owned: __________ Inside/outside____________
Personal References (other landlords or someone you pay regularly, NOT FAMILY MEMBERS)
Name______________________________________Yrs. Known____ Phone #___________________
Name______________________________________Yrs. Known____ Phone #__________________
Name______________________________________Yrs. Known____ Phone #__________________
Total number of adults___________Total number of children living with you under the age of 18_____________
Names and relationship of all who will live in home with you ___________________________________________________________________________________________
___________________________________________________________________________________________
IN EMERGNECY NOTIFY: _____________________Relationship:______________Phone:________________
I/We certify the foregoing to be true and accurate. The owner/agent has my consent to investigate my credit / criminal and / or verify my employment and references. If any information obtained causes my application to be rejected, I understand that information may not be disclosed to me. Agent has the responsibility to offer equal service to all prospects without regard to race, color, religion, sex, handicap, familial statue or national origin. You are hereby advised that this agent and firm represent the owner and/or signature below acknowledges that this information has been disclosed to you. I understand there is a $30.00 application fee to pay with this application.
Signature________________________________________________________________Date_______________
Signature________________________________________________________________Date________________