Rental Application

Lansford Realty and Property Management

1447 Vance Road – Suite 105 – Chattanooga, TN 37421 Phone 423 710-3378 Fax 1 800 606-7104

Instructions: Each applicant age 18 or over must complete a Rental Application Form accompanied by a $20 application fee. After submitting application, please click on Application Fee to make payment. Optionally you can download this APPLICATION and mail or bring by our office with your application fee. You will also be required to provide income verification.

RENTAL APPLICATION

Equal Housing Opportunity

The undersigned hereby makes an application to rent the following property:


Anticipated move date of at a monthly rent of $ and damage deposit of $.

PLEASE TELL US ABOUT YOURSELF
Full Name:
Home Phone:
Date of Birth:
Social Security#
Email Address
Other Phone:
Co-Applicant Name:
Co-Applicant Date of Birth:
Social Security #:
Names of Dependents:
Dependents Date of Birth:
List All Pets:

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)

Current Address Apt# City

State Zip

Month/Year Moved In

Reasons For Leaving

Rent $ :
Owner/Agent :
Phone:
Previous Address (last 3 years) :
Rent $ :
Owner/Agent :
Phone :

PLEASE DESCRIBE YOUR CREDIT HISTORY

Have you declared bankruptcy in the past seven (7) years?

YesNo

Have you ever been evicted from a rental residence?

YesNo

Have you had two or more late rental payments in the past year?

YesNo

Have you ever willfully or intentionally refused to pay rent when due?

YesNo

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION

Your Status:
Full TimePart TimeStudentUnemployed

Employer
Dates employed
Employed as
Supervisor Name
Phone
Salary $
per .
(If employed by above less than 12 months, give name & phone of previous employer or school)

If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application.

Amount $ Source/Contact

Name

Co-Applicant

Your Status: Full TimePart TimeStudentUnemployed

Employer
Dates employed
Employed as
Supervisor Name
Phone
Salary $
per .
(If employed by above less than 12 months, give name & phone of previous employer or school)

If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application.

Amount $ Source/Contact

Name

PLEASE LIST YOUR REFERENCES

Personal Reference or Emergency Contact:

Name Address
Phone Relationship

Driver's License

Your Driver's License Number State

Vehicle Information:

Make / Model Year
License Plate State

ADDITIONAL INFORMATION:

Please give any additional information that might help owner/management evaluate this application?

Where may we reach you to discuss this application?

Day Phone #

Night Phone #

I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application.

I hereby deposit $as earnest money to be refunded to me if this application is not accepted in 3 business banking days. The home will not be removed from the rental market unless applicant has paid the security deposit. Upon acceptance, this deposit shall be retained as part of the damage deposit. When so approved and accepted, I agree to execute a lease for months before possession is given and to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.

The above information, to the best of my knowledge, is true and correct.

Please sign:(Name of Applicant) Date

AUTHORIZATION



Release of Information

I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.

Name (please print):
Signature Date

APPLICANT:PLEASE DO NOT WRITE BELOW(FOR OFFICE USE ONLY)


Deposit of $ Received by
Date :

OFFICE NOTES:

Application Fee