Sample Page

PROPERTY INFORMATION
Property applying for		Real Estate Agent's Name
Desired Move In Date		How Did You Find The Property?	Friend is Tenant HAR.com Homes.com Newspaper Other Realtor Sign Trulia
PERSONAL INFORMATION
First Name		Last Name
Home Phone		Mobile Phone
Email Address		Social Security Number
Date of Birth		Driver's License Number	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Marital Status	Single Married Divorced	Citizenship (country)
CURRENT ADDRESS
Street Address 1
Street Address 2
City	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip
Landlord's Name		Landlord's Phone Number
Move In Date		Rent Amount $
Reason for move
PREVIOUS ADDRESS
Street Address 1
Street Address 2
City	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip
Landlord's Name		Landlord's Phone Number
Move In Date		Move Out Date
Rent Amount $
Reason for move
OTHER THAN SELF, NAME ALL PERSONS WHO WILL OCCUPY PROPERTY
Name Relationship Age Name Relationship Age Name Relationship Age Name Relationship Age
PETS
Pet 1 Type (dog, cat, etc) Pet 1 Breed Pet 1 Size (lbs) Pet 1 Color Pet 2 Type (dog, cat, etc) Pet 2 Breed Pet 2 Size (lbs) Pet 2 Color
EMPLOYMENT & INCOME INFORMATION
Current Employer's Name (Company)		Position
Net Monthly Income		Start Date
Supervisor's Name		Supervisor's Phone Number
Previous Employer's Name (Company)		Position
Net Monthly Income		Start Date
		End Date
Supervisor's Name		Supervisor's Phone Number
Other Income $		Describe other income
BACKGROUND INFORMATION
Anyone who occupies the property smoke?		Yes   No
Will applicant maintain renter's insurance?		Yes   No
Is any occupant a registered sex offender?		Yes   No
Are there any criminal matters pending against any occupant?		Yes   No
Has applicant ever:
been evicted?		Yes   No
been asked to move out by a landlord?		Yes   No
breached a lease or rental agreement?		Yes   No
filed for bankruptcy?		Yes   No
lost property in a foreclosure?		Yes   No
had any credit problems, slow pays or delinquencies?		Yes   No
been convicted of a crime?		Yes   No
If answered yes above, please describe
Is there additional information applicant wants considered?		Yes   No
Describe additional information
After clicking submit you will be immediately taken to a payment screen. Your application will not be submitted unless you successfully make a payment in the amount of $35.00 on the next page. Application payments are not refundable under any circumstances. Please be sure you have read and understand our Tenant Selection Criteria before making your application fee payment. By clicking submit, you give permission to Cole Realty & Management, its agents, and/or assigns to obtain a copy of your credit report from any consumer reporting agency and to obtain background information about you. You also give permission to verify employment information provided on this form by contacting current/previous employers, as well as contact current/previous landlords to obtain information about your rental history.
	I have read and understand the Cole Realty Tenant Selection Criteria.
	I understand that application fees are not refundable for any reason.