RENTAL APPLICATION FOR:                                                                                                            
Address of Rental _______________________________________________________________________

*APPLICANT:                                                                         

Social Security Number                                                     Date of Birth_________________________

Home Phone                                         Work                                         Cell                                  
Present Address                                                                                                                                  

Name of current Landlord                                               Phone number                                           

How long at present address?                 Reason for leaving___________________________________ 

If present address is less than one year, please list prior address, Landlord’s name and number:

                                                                                                                                                          
_______________________________________________________________________________________ 

Name all other occupants that will be living in the home and the relationship to applicant:
                                                                                                                                                

A RENTAL APPLICATION IS REQUIRED FOR ANY OCCUPANT OVER THE AGE OF 18.

Pets (number and type)                                                                                                                         

Present Employer                                                                                              

How long with this Employer?                                                                              

Supervisors Name                                                                                             

Supervisors phone number                                                                             

Position or Title                                                                                             

Gross Income $                          per                                                              

Other Income                                                                                                  
Source                                                                                                   

Drivers license no                                                       Expiration Date                 

*CO-APPLICANT:                                                                       

Social Security Number                                                     Date of Birth                                          

Home phone                                Work                                         Cell                                           

Present Address                                                                                                                                        

Name of current Landlord                                                 Phone number                                         

How long at present address?                   Reason for leaving                                                        
                                                                                                                                                   

If present address is less than one year, please list prior address, Landlord’s name and number:

Present Employer                                    How long with this Employer?                                        

Supervisors Name                                             Supervisors phone number                                  

Position or Title                                                                                                                              

 Gross Income $                        per                             

Other Income                                                      Source                                                                

Drivers license no.                                             Expiration Date                                                      

Do you plan to use liquid filled furniture?              Type                                                                     

Has either applicant been a party of an unlawful detainer within the last 7 years?                                 

If Yes, please explain                                                                                                                   
                                                                                                                                                   

Has either party filed for bankruptcy within the last 7 years?                                   If yes, please explain:                                                                                                                                            
                                                                                                                                                       
 

Applicants represent the above information to be true, correct and hereby authorize verification of the above information provided, including obtaining credit reports at the actual cost of $20.00 to be paid by applicants.  The cost of the credit report is not a deposit or rent, and will not be applied to future rent or refunded, even if the rental  application is declined.  Applicants understand that the landlord may terminate any rental agreement entered into for misrepresentation made above.

WE WILL BE UNABLE TO PROCESS THIS APPLICATION IF NOT COMPLETED IN FULL
 

Applicant Signature                                                                         Date                                                           

Co-Applicant Signature                                                                    Date                                                           

If necessary I give PHM permission to verify my Financial Aid status