Rent To Own Homes - Application for Lease with Option To Buy
Please fill out as completely as possible.
Each applicant 18 years or older will neet to fill out a seperate application.

Property Wanted? ________________ Date Wanted? __________________

Applicant #1 (full name) ______________________________________
Social Security # ___________	Date of Birth ________
Martial Status	Email Address ________
Current Address _________________	City _______________
State ________________ Zip _________	Telephone # ____________
Current Landlord _____________________	Telephone # ____________
How Long at Current Address? ________	Rent Amount $ _____ /mo
Reason for Moving? ___________________________________
Previous Address _____________________	City _______________
State ________________ Zip ________	How Long? _______
Previous Landlord _________________	Telephone # _______
Employer ____________________	Personal Phone # _______
Employer's Address ___________________________ Zip ________
Position Held ______________________	How Long? _________
Annual Employment Income $ __________	Additional Income $ _________
Describe Sources of Additional Income _________________________
Phone # if Applicable ____________

Credit References

Name/Address of Bank _______________________ Zip ______
Credit Cards Held ____________________________________________________
Make and Year of Car ____________	License Plate # _____________
Driver's License # ______________	Registration # __________
In Case of Emergency, Contact:
Name _____________________________	Relationship ______ Tel# _____
Address ________________________________________________________
City ___________________________________	State ________ Zip _____
Emergency Contact #2:
Name ________________________________________ Tel # _________
Please List All Other Persons Who Will Reside at this Residence:
Name __________________________ Relationship _____ D/O/B _________
Name __________________________ Relationship _____ D/O/B _________
Name __________________________ Relationship _____ D/O/B _________
Name __________________________ Relationship _____ D/O/B _________
Name __________________________ Relationship _____ D/O/B _________
Name __________________________ Relationship _____ D/O/B _________

This does not represent an offer to lease, but is an application only. Nothing will be binding on either party unless, and until a Lease is fully executed by both the Landlord and Tenants (s).

I hereby authorize the persons listed above to release to the Landlord any information contained in this application, in order to process this application.

I hereby warrant that all my representations set forth above are true.

Signature ____________________________________________  Date _________________________

Received by ____________________________________________  Date _________________________