Lease Application

Name *

First

Last

Email Address *

Phone Number *

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Building Located at: *

Description of Area Rented *

Occupancy Date *

Rent

Deposit

Utilities Included: *

Planned Use of Area Rented: *

INDIVIDUAL OR PARTNERSHIP INFORMATION

(Please fill out separate application for each partner)

Name of Business *

Name of Owner *

Social Security Number: *

Address

Address Line 1

City

State

Zip Code

Name of Co-Owner: *

Social Security Number: *

Name of Co-Owner:

Social Security Number:

CORPORATE INFORMATION

Name of Corporation: *

Subsidiary of: *

Chief Executive Officer: *

President:

Vice-President:

Secretary:

Treasurer:

Federal Tax Identification Number: *

BUSINESS INFORMATION

How many years has this business been in operation? *

Present Business Address:

Address Line 1

City

State

Zip Code

Present Landlord or Mortgage Holder: *

Telephone:

Amount of Rent/Mortgage Payment:

Reason for Moving:

Present Business Address:

Address Line 1

Address Line 2

City

State

Zip Code

Present Landlord or Mortgage Holder:

Telephone:

Amount of Rent/Mortgage Payment:

Reason for Moving:

CREDIT REFERENCES

Bank:

Branch:

Checking Account No:

Savings Account No:

Name of Company:

Account #:

Address:

Telephone:

Name of Company:

Account #:

Address:

Telephone:

Name of Company:

Account #:

Address:

Telephone:

EMERGENCY INFORMATION

In case of after-hours emergency please notify: *

Address: *

Telephone:

In case of personal emergency please notify:

Name: *

Relationship:

Address: *

Telephone: *

APPLICANT ACKNOWLEDGEMENT

Please Read the Following Statement Carefully. If you agree to the statement, type in "I (your name) agree" in the box after the statement. We cannot process this application unless you do this. Applicant acknowledges that this application process is a pre-screening tool for the Landlord for the purposes of pre-qualification. Applicant will still be required to fill out and sign a written application for final approval. Applicant hereby consents to routine inquiry of references and credit agencies to provide applicable information concerning applicant's character, address, creditworthiness, reliability, and income and hereby authorizes references named here to release this information. This application is for pre-qualification only. This application is NOT a rental agreement, contract, or lease! There is NO Earnest Money being submitted with this application. All applications are subject to the approval of the owner or managing agent. I warrant that I am at least 18 years of age and that all statements herein are true and correct, to the best of my knowledge.

Acknowledgement (Printed Name): *

Date *

INDIVIDUAL OR PARTNERSHIP INFORMATION

CORPORATE INFORMATION

BUSINESS INFORMATION

CREDIT REFERENCES

EMERGENCY INFORMATION

APPLICANT ACKNOWLEDGEMENT

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