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
Credit Report: (Favorable/Unfavorable) By:___________________________________________
Other Comments:__________________________________________________________________
___________________________________________________________________________________
Deposit: _____________________ Monthly Rent ______________
Unit Applied For:___________________________________________________________________
Terms of Lease _______________________
Move-in Date ___________________ Lease Expires ______________ Num. Keys ___________
Total Number of Occupants _________________________
Separate Pet Deposit _________________________
Utilities to be paid by tenants Gas □ Electric □ Water □
If you have a question about the interpretation or legality of this form please consult an attorney or other qualified person.