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Samir Rafeedie
Realty Ambassadors
Serving The Valley of the Sun

and Prescott Areas
Phoenix Area: (623) 815-1900
Prescott Area: (928) 606-5512

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Rental Applications

APPLICATION FOR OCCUPANCY
Each Adult (18 or older) must fill out a separate application

 

 

MOVE-IN INFO

Today’s Date:      _________________________     Requested Occupancy Date: _________­­­­­­_____________

Rental Property Address: ____________________________________         Rent Amount:______________

 

APPLICANT INFO

First Name:    _______________________    Last Name:    _______________________________

 SSN:     _____________________________  Birth Day:      _______________________________

 Phone: _____________________________  Cell Phone:    _______________________________

 Email:   ____________________________  DL License:    ______________________________

 

CO-APPLICANT INFO

First Name:    _______________________  Last Name:    _______________________________

 SSN:     ____________________________  Birth Day:      _______________________________

 Phone: ____________________________   Cell Phone:     _______________________________

 Email: ____________________________   DL License:   _______________________________

 

ADDITIONAL OCCUPANTS

Name: ____________________________ Relationship: ___________________ Age: ________

Name: ____________________________   Relationship: ___________________ Age: ________

 Name: ____________________________   Relationship: ___________________ Age: ________

 Name: ____________________________   Relationship: ___________________ Age: ________

 

CURRENT ADDRESS

Address:         _________________________________________________________________________

 City:   _____________________________     State: _____________       Zip: _______________

 Landlord:__________________________     Phone: ____________________________________

 _____

Mortgage Co: ______________________     Account #:  _________________________________

 How Long:      ________     Reason for Leaving: _________________________________________
Current Rent/Mortgage Payment _________________________

 

 

PREVIOUS ADDRESS

Address:         _________________________________________________________________________

 City:   _____________________________     State: _____________       Zip: ____________

 Landlord: _____________________________     Phone:          _______________________________

 Mortgage: _____________________________      Account #:  _______________________________

 How Long:________     Reason for Leaving: _____________________________________________

 Rent/Morgage Payment __________________

 

 

EMPLOYMENT HISTORY

Company:       ______________________________________________________________________

 Manager:       ______________________________        Phone: ______________________________

 Address:         _________________________________________________________________________

 City:                _____________________________     State: _____________       Zip: _______________

 Dates: From   ___/___/____ To: ___/___/______   Pay: _______ Per Yr__ Per Mo __Per Wk __Hr __

 If Less than 2 years, Complete

 Previous Co:   _________________________________________________________________________

 Manager:       ________________________________        Phone: ______________________________

 Address:         _________________________________________________________________________

 City:                _____________________________     State: _____________       Zip: _______________

 Dates: From   ___/___/____ To: ___/___/______   Pay: _______ Per Yr__ Per Mo __Per Wk __Hr __

 

 

CO-APPLICANT EMPLOYMENT HISTORY

Company:       _________________________________________________________________________

 Manager:       ________________________________        Phone: ______________________________

 Address:         _________________________________________________________________________

 City:                _____________________________     State: _____________       Zip: _______________

 Dates: From   ___/___/____ To: ___/___/______   Pay: _______ Per Yr__ Per Mo __Per Wk __Hr __

 If Less than 2 years, Complete

 Previous Co:   _________________________________________________________________________

 Manager:       ________________________________        Phone: ______________________________

 Address:         _________________________________________________________________________

 City:                _____________________________     State: _____________       Zip: _______________

Dates: From   ___/___/____ To: ___/___/______   Pay: _______ Per Yr__ Per Mo __Per Wk __Hr __

 

 

 

ADDITIONAL INCOME

 Source:           _______________________________          Amount: ____________ Per___________

 Contact:          _______________________________          Phone: _______________________________

 

 

BANKING INFO

 Bank:  ____________________________    Acct #: ___________________     Phone: ______________

 Bank:  ____________________________    Acct #: ___________________     Phone: ______________

 

 

PERSONAL REFERENCES

 Name: _________________________    Relationship: _________________    Phone: _______________

 Name: _________________________    Relationship: _________________    Phone: _______________

 Name: _________________________    Relationship: _________________    Phone: _______________

 

 

EMERGENCY INFO

Name: _________________________    Relationship: _________________    Phone: _______________

 

 

AUTOMOBILE INFO

 Make: _________________________    Model: ______________________   Plate: ________________

 Make: _________________________    Model: ______________________    Plate: ________________

 

 

PET INFO

Type:  ________________________    Breed: _______________________    Weight: _______________

 Type:  ________________________    Breed: _______________________    Weight: _______________

 

 

ADDITIONAL INFO (IF YES, PLEASE EXPLAIN & GIVE DATES)

 Ever convicted of a crime?:   Yes _____ No _____ Explain: ___________________________________

 Ever been evicted?:               Yes _____ No _____ Explain: ___________________________________

 Ever filed bankruptcy?:         Yes _____ No _____ Explain: ___________________________________

 

 

 

APPLICANT ACKNOWLEDGEMENT

I understand that this application is not a Lease Agreement and that it does not create any obligation on the part of the Landlord/Property Manager.

I understand that I will be charged a $50/Adult non-refundable fee to apply. I am not entitled to a refund
even if this application is rejected.

I understand that the information provided may be used to determine whether to accept this application. I authorize Landlord/Property Manager to verify all the information given including rental history,      employment history, personal references, and to obtain a current credit report and perform a criminal background check.

 I represent that the information provided in this application is true, complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of information is grounds for rejection of my application.

 

____________________________________                        ___________________________________

Applicant Signature                           Date                            Co-Applicant Signature                     Date



Samir Rafeedie | 623-815-1900 | Contact Me
Serving The Valley of the Sun and Prescott Areas
Copyright © 2017, All Rights Reserved

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