RE/MAX REALTY CONSULTANTS

Property Management Division

2731 Horse Pen Creek Road

Greensboro, NC 27410 (336) 217-9326

Rental Application

 Instructions:  A separate application must be filled out by each applicant (even if married). Completely fill out each blank and sign where indicated. A $25.00 fee must accompany this application.

APPLICANT____________________________________________________________________________________________

MARITAL STATUS:   □ Single   □ Married since (date) ___________   Best Contact Number (____)____________________

BIRTH DATE: ________________   SS# _____________________ DRIVERS LICENSE     State ______ # _____________________

Present                                                                     City/                                                                     Rent/                   

Address ________________________________State/Zip _________________ Since ________ Month __________ 

Present Phone (____)_____________

Present                                                                                                                          City

Landlord ___________________________ Address ________________________ State/Zip ____________________

Phone (____) ______________

Is present rent up to date? □ Yes □ No    Have you given notice?    □ Yes □ No   Have you been asked to leave?    □Yes □No

Previous                                                                 City/                                                                     Rent/                   

Address ________________________________State/Zip _________________ Since ________ Month __________ 

Present Phone (____)   ______________

Previous                                                                                                                       City

Landlord ___________________________ Address ________________________ State/Zip ____________________

Phone (____)   ______________

Was rent up to date? □ Yes □ No     Had you given notice?  □ Yes   □No    Had you been asked to leave?   □Yes □No

Number to occupy _____________

                           NAME                                              RELATIONSHIP                                         BIRTH DATE

PETS:     □ Yes      □ No    If yes, give details (number, type & size)

Make/Model/color #1________________________________________License Plate #1 _________________State _____

Make/Model/color #2 _______________________________________License Plate #2 _________________State _____                  

PREVIOUS                                                                                         CURRENT

EMPLOYER ___________________________Since _______EMPLOYER ___________________________   Since  _______

Address    _________________________________________ Address _____________________________________________

Job Position _______________________________________  Job Position___________________________________

Supervisor ___________________ Phone (___)___________  Supervisor ________________ Phone (___)__________  Hrs._______                                                                                 Hrs._______

Current Income     $______________Weekly/Biweekly/Monthly/Yearly   Source________________________________________

Current Income     $______________Weekly/Biweekly/Monthly/Yearly   Source________________________________________

Current Income     $______________Weekly/Biweekly/Monthly/Yearly  Source________________________________________

Bank/Credit Union __________________ Acct.# _____________________

Bank/Credit Union __________________ Acct.#______________________

                                                                                                                                         Non-Relative

Relative ______________________Relation ____________Reference ___________________________Phone (____) ______________

Address ________________________________________  Address ______________________________________________________

Phone (____) ______________

Non-Relative         

Reference _______________________________________Phone (____) _________________________

Emergency Contact __________________________________Phone (____) ______________________

Current (open) include Credit Card(s)

CREDITORS NAME                                       ADDRESS                              ACCOUNT #               PAYMENT     CURRENT

_____________________________________________________________________________      $____________        □Yes □No

_____________________________________________________________________________      $____________        □Yes □No

_____________________________________________________________________________      $____________        □Yes □No

_____________________________________________________________________________      $____________        □Yes □No

_____________________________________________________________________________      $____________        □Yes □No

Explain any "YES" answers on back with names and details.

Has any signer ever been sued for bills? □Yes □No           Has any signer ever been sued for eviction? □Yes  □No

Has any signer ever been bankrupt?     □Yes □No              Has any signer ever been guilty of a felony? □Yes  □No

Has any signer ever broken a lease?      □Yes □No              Is the total move-in amount available now (rent and deposit)? □Yes  □No

Applicant authorizes the owner to contact past and present landlords, employers, creditors, credit bureau, neighbors and any other sources deemed necessary to investigate applicant.

All the information is true, accurate and complete to the best of applicant's knowledge.  Owner reserves the right to disqualify tenant if information is not as represented.

I UNDERSTAND THAT IF MY APPLICATION IS ACCEPTED, I MUST PROVIDE PROOF OF "RENTERS INSURANCE" FOR THE LENGTH OF MY LEASE, BEFORE I WILL BE GIVEN THE KEYS TO RENTAL PROPERTY.

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

X____________________________________________________    __________________

  APPLICANT                                                                                               DATE

RENTER INSURANCE MUST BE PRESENTED TO LANDLORD PRIOR TO OCCUPANCY

DO NOT WRITE BELOW THIS LINE

THIS SECTION TO BE COMPLETED BY INTERVIEWER

If you have a question about the interpretation or legality of this form please consult an attorney or other qualified person.