JBas Realty, LLC. Rental Application

PROPERTY

Property: *

PERSONAL INFORMATION

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Date of Birth: *

Marital Status: *

Social Security #: *

Drivers License #: *

State: *

Present Landlord: *

Landlord Phone: *

Amount of Rent: *

Length of Time at Property: *

Reason for Leaving: *

Is your present rent up to date?: *

Previous Address:

City / State / Zip:

Previous Landlord:

Landlord Phone:

Amount of Rent:

Length of Time at Property:

Reason for Leaving:

Is your present rent up to date?:

Next Previous Address:

City / State / Zip:

Next Previous Landlord:

Landlord Phone:

Amount of Rent:

Length of Time at Property:

Reason for Leaving:

Is your present rent up to date?:

PROPOSED OCCUPANT(S) - Besides You

Name:

Relationship:

Occupation:

Date of Birth:

Name:

Relationship:

Occupation:

Date of Birth:

Name:

Relationship:

Occupation:

Date of Birth:

Name:

Relationship:

Occupation:

Date of Birth:

VEHICLE(S) INFORMATION

Year:

Make:

Model:

Color:

Plate #:

State:

Year:

Make:

Model:

Color:

Plate #:

State:

EMPLOYMENT

Current Employer: *

Occupation: *

Hours/Week: *

Supervisor: *

Phone: *

Years Employed: *

Address: *

City / State / Zip: *

Previous Employer:

Occupation:

Hours/Week:

Supervisor:

Phone:

Years Employed:

Address:

City / State / Zip:

INCOME

Current Income: *

Source: *

Proof of Income: *

Current Income:

Source:

Proof of Income:

Current Income:

Source:

Proof of Income:

EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relation:

Address:

City / State / Zip:

Emergency Contact:

Phone:

Relation:

Address:

City / State / Zip:

PERSONAL REFERENCE INFORMATION

Personal Reference:

Phone:

Relation:

Address:

City / State / Zip:

Personal Reference:

Phone:

Relation:

Address:

City / State / Zip:

APPLICANT QUESTIONNAIRE

Has applicant ever been sued for bills? *

Has applicant ever been locked our of their apartment by the sheriff? *

Has applicant ever been bankrupt? *

Has applicant ever been brought to court by another landlord? *

Has applicant ever been guilty of a felony? *

Has applicant ever moved owing rent or damaged an apartment? *

Has applicant ever broken a lease? *

Do you have an active checking or savings account? *

Is the total move-in amount available now (rent and deposit)? *

Applicant authorizes the landlord to contact past and present landlords, employers, creditors, credit bureaus, references, and any other sources deemed necessary to investigate applicant. All information is true, accurate and complete to the best of applicant’s knowledge. Landlord reserves the right to disqualify tenant if information is not as represented. Any person or firm is authorized to release information about the undersigned upon presentation of this form or a photocopy of this form at any time.

Please check the below box to agree to our disclaimer. *

I Agree