Application

APPLICATION TO LEASE
Date Rental Needed:
Preferred Unit:
Full Name:
SS#:
CURRENT PHYSICAL ADDRESS (No PO Box):
Street Address City State / Province / Region ZIP / Postal Code
How long have you lived at this address?
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Date of Birth:
Month
Day
Year
Driver's License #:
Are you a member of the US Military?
If yes are you active duty?
SPOUSE or CO-APPLICANT AND DEPENDENT INFORMATION
Co-Applicant Full Name:
SS#:
Date of Birth:
Month
Day
Year
Age:
Driver's License #:
Home Phone:
Work Phone:
Cell Phone:
Additional Occupants
Name Sex Age Relationship

List all occupants by name, sex, and age (indicate if related or non-related)

ADDITIONAL INFORMATION
Emergency Contact:
Telephone Number:
Address:
Relationship to Applicant:
If Renting, Current Landlord:
Telephone:
Reason for moving from Current Address:
PAST RENTAL HISTORY
Have you ever forfeited (or lost) a security deposit to a past Landlord? If yes, explain:
Has a judgement ever been filed against you for non-payment of debts or rent? If yes, explain:
Have you ever been evicted from your home/apartment? If yes, explain:
Do you have a criminal record? If yes, explain:

Premier Properties Realty Group, LLC (PPRG) requires the following:
PPRG reserves the right to pull criminal record for any or all applicants. PPRG reserves the right to deny any Applicant based on criminal record. Rental history will be verified. If Applicant has current or prior rental history, PPRG requires contact information so that we may verify payment history and tenancy. PPRG reserves the right to approve/deny any Applicant based on the discretion of Management. It is my understanding that this application is preliminary only and involves no obligation of the owner or its Agent to approve this Application or to deliver occupancy of the proposed premises. If this application is accepted, the security deposit will be applied to the lease and damages agreement and Applicant forfeits all claims to the security deposit as liquidated damages if Applicant cancels after acceptance. The above information is true and accurate to my knowledge. By signing this application, I give permission to Premier Properties Realty Group, LLC to verify by phone/fax or other means any information I have listed. I also understand that my credit may be verified by a credit report and hereby authorize such verification. I understand my criminal record may be verified by a criminal record report and hereby authorize such verification. Applicant has read and understands the requirements for the Application.
Signature of Applicant:
Date:
MM slash DD slash YYYY

APPLICATION TO LEASE

Name	Sex	Age	Relationship