RENTAL APPLICATION - ONLINE FORM
Equal Housing Opportunity
__________________________________________________________________________________________________________

Please fill out the fields below, and click the submit button. We will contact you shortly to follow-up.

The party below is making application for a 3 Bedroom, 2.5 Bathroom home located at: 9814 Sovereign Way, Wake Forest, NC 27587

Anticipated move date of at a monthly rent of $ 1150.00 and security deposit equal to 1 month's rent (if you qualify).


PLEASE TELL US ABOUT YOURSELF

Full Name
Home Phone
Other Phone
Date of Birth
Email Address:

Co-Applicant Name
Co-Applicant Phone
Co-Applicant Date of Birth
Co-Applicant Email Address


Names of Dependents
Dependents Dates of Birth


List All Pets:


PLEASE GIVE RESIDENTIAL HISTORY

Current Address Apt# City State Zip
Month/Year Moved In Reasons for Leaving Rent $
Owner/Agent Owner/Agent's Phone

Previous Address Rent $
Owner/Agent Prev Owner/Agent Phone

PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past seven (7) years? Yes No
Have you ever been evicted from a rental residence? Yes No
Have you had two or more late rental payments in the past year? Yes No
Have you ever willfully or intentionally refused to pay rent when due? Yes No
What is your credit score (if known)?

PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: Full Time Part Time Student Unemployed
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 (Check this box If you'd like to give us this information later)

Please do not use family members as references.

Personal Reference or Emergency Contact 1
Name
Address
Phone Relationship

Personal Reference or Emergency Contact 2
Name
Address
Phone Relationship

Personal Reference or Emergency Contact 3
Name
Address
Phone Relationship

Driver's License:
Your Driver's License Number State

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

I hereby apply to lease the above described premises for the term and upon the set conditions above set forth, but understand that I am not obligated to
sign a lease.

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.

By clicking the "submit" button I agree to the statements in this document and I warrant that all information above set forth are, to the best of my knowledge, true and correct..



If you'd rather print and fax this application, Sign here X_______________________________________ and fax to 919-573-9621