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Rental Application

Step 1 of 14

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Check List for Support Documentation to be included with the application:
- Non-refundable Application fee of $45.00 for EACH applicant 18 yrs of age and over
- Your 2 most recent current employment paycheck stubs as proof of income
- If self-employed or commissioned employee, please include last year’s tax returns and YTD income
- A legible copy of each applicants’ driver’s license
- A legible copy of each applicants’ social security card
- Previous landlords phone and fax number for a landlord verification
- We will not run the application unless all the above items are included
WE RUN THE FIRST COMPLETED APPLICATION WE RECEIVE FOR EACH PROPERTY

Note: Please complete the following information and sign below as your authority to release this information to the property owner. Only provide adult applicants (18yrs and older) info only (no children necessary)

Each applicant 18 years of age and older is required to fill out their own application. In the space below please list all adult applicants (18 years and older) who will be filling out an application for your chosen rental property. We will run a credit and criminal background check once we receive an application for each of the names you list below.
About the Property
Applying for Rental Residence Located At*
Street Address Address Line 2 City State ZIP Code
Requested Move In Date*
Date Format: MM slash DD slash YYYY
Rental Amount
Name of your Realtor*
If you don't have one, type "none"

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Your Personal Information
Name*
Prefix First Middle Last Suffix
Social Security Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Drivers License/ID Number*
State which issued Driver's License/ID*
State
Mobile Phone*
Alternate Phone*
Email*
List of Applicant Names Applying with you
Please note: only one adult applicant needs to list all child applicants (17 years of age and younger) on their application.

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Applicant History - Current Residence
Current Address*
Street Address Address Line 2 City State ZIP Code
Current Landlord Name*
Current Landlord Phone*
Current Landlord Fax
Current Rent Amount*
Current Residence Original Move-in Date*
Date Format: MM slash DD slash YYYY
Current Residence Move-Out Date*
Date Format: MM slash DD slash YYYY

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Applicant History - Previous Residence
Previous Residence Address
Street Address Address Line 2 City State ZIP Code
Previous Residence Landlord Name
Previous Residence Landlord Phone
Previous Residence Landlord Fax
Previous Residence Rent Amount
Previous Residence Original Move-in Date
Date Format: MM slash DD slash YYYY
Previous Residence Move-Out Date
Date Format: MM slash DD slash YYYY

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Employment History - Current Employer
Current Employer Name*
Current Employer Phone*
Current Employer Fax
Current Employer Address*
Street Address Address Line 2 City State ZIP Code
Current Employer Original Start Date*
Date Format: MM slash DD slash YYYY
Current Employer Job Title*
Current Employer Supervisor Name*
Current Employer Monthly Income*

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Employment History - Previous Employer
Previous Employer Name
Previous Employer Phone
Previous Employer Fax
Previous Employer Address
Street Address Address Line 2 City State ZIP Code
Previous Employer Original Start Date
Date Format: MM slash DD slash YYYY
Previous Employer Job Title
Previous Employer Supervisor Name
Previous Employer Monthly Income

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List individuals that will be occupying the unit
Occupant 2
Occupant 2 Name
First Last
Relationship with Occupant 2
Occupant 2 Date of Birth
Date Format: MM slash DD slash YYYY
Occupant 3
Occupant 3 Name
First Last
Relationship with Occupant 3
Occupant 3 Date of Birth
Date Format: MM slash DD slash YYYY
Occupant 4
Occupant 4 Name
First Last
Relationship with Occupant 4
Occupant 4 Date of Birth
Date Format: MM slash DD slash YYYY

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Have you ever broken a rental agreement?*
- Yes
- No
Have you ever been evicted for any reason?*
- Yes
- No
Have you ever had a forcible detainer filed against you?*
- Yes
- No
Have you ever been convicted of a crime?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
Have you ever had any credit problems?*
- Yes
- No
Have ever filed for bankruptcy?*
- Yes
- No
Bankruptcy File Date (if applicable)
Date Format: MM slash DD slash YYYY
Bankruptcy Discharge Date (if applicable)
Date Format: MM slash DD slash YYYY
Have you ever used any other names?*
- Yes
- No
Please tell us about all other used names and when you've used them (if applicable)
Do you receive additional income?*
- Yes
- No
Name of Additional Income Source (if applicable)
Monthly Income of Additional Source (if applicable)

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Will there be any pets in the unit?*
Pet 1
Pet 1 Name
Pet 1 Type and Breed
Pet 1 Weight
Pet 1 License #
Pet 1 Color
Pet 2
Pet 2 Name
Pet 2 Type and Breed
Pet 2 Weight
Pet 2 License #
Pet 2 Color

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How many vehicles do you plan to parking on the property?
Vehicle 1
Vehicle 1 Make
Vehicle 1 Model
Vehicle 1 Year
Vehicle 1 Color
Vehicle 1 License Number
Vehicle 1 License State
State
Vehicle 2
Vehicle 2 Make
Vehicle 2 Year
Vehicle 2 Model
Vehicle 2 Color
Vehicle 2 License Number
Vehicle 2 License State
State
Vehicle 3
Vehicle 3 Make
Vehicle 3 Model
Vehicle 3 Year
Vehicle 3 Color
Vehicle 3 License Number
Vehicle 3 License State
State
Vehicle 4
Vehicle 4 Make
Vehicle 4 Model
Vehicle 4 Year
Vehicle 4 Color
Vehicle 4 License Number
Vehicle 4 License State
State

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Emergency Contact 1
Emergency Contact 1 Name*
First Last
Emergency Contact 1 Address*
Street Address Address Line 2 City State ZIP Code
Relationship with Emergency Contact 1*
Emergency Contact 1 Phone*
Emergency Contact 2
Emergency Contact 2 Name
First Last
Emergency Contact 2 Address
Street Address Address Line 2 City State ZIP Code
Relationship with Emergency Contact 2
Emergency Contact 2 Phone
Emergency Contact 3
Emergency Contact 3 Name
First Last
Emergency Contact 3 Address
Street Address Address Line 2 City State ZIP Code
Relationship with Emergency Contact 3
Emergency Contact 3 Phone

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Please Read Carefully

Applicant represents that all of the above statements are true and complete, and hereby authorizes verification of above information, references, criminal checks and credit records. Applicant(s) acknowledges that false information contained herein constitutes grounds for rejection of this application. This application is preliminary only and does not obligate the owner or representative to execute a lease or deliver possession of the proposed premises. Should any statement made be misrepresented or false, all deposits shall be forfeited. Applicant(s) understand that if, after approval, they choose not to rent this property for any reason, all deposits placed with Provident Partners Companies Property Management are forfeit and no exceptions will be made. Provident Partners Companies Property Management reserves the right to verify application information after move in and may convert the proposed Rent Agreement to a month to month term if misleading information is contained in this application.
By signing below, Applicant(s) attest to the fact they have read and accepted this application and that all of the statements included in this application are true and correct.
Applicant Signature (Please Type Your Full Name)*
Date Signed*
Date Format: MM slash DD slash YYYY

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Charge Card Authorization Form for Tenant Application Background Check
I hereby authorize Provident Partners Companies Property Management, Inc. to charge my credit card account in the amount of $45.00 for the first applicant and $40.00 for each additional applicant 18 years of age or older.
Cardholder Name*
First Last
Billing Address*
Street Address Address Line 2 City State ZIP Code
Cardholder Phone*
Cardholder Drivers License or ID Number*
State which issued the cardholder's Driver's License/ID*
State
Cardholder Date of Birth*
Date Format: MM slash DD slash YYYY
Credit Card Type*
- Visa
- MasterCard
Credit Card Number*
Credit Card Expiration*
Format is Month and Year only (MMYY)
Credit Card Verification Number (CV2)*
Cardholder Signature (Type Full Name Below)*
As the credit card holder, I hereby authorize Provident Partners Companies Property Management, Inc. to charge the above referenced account.

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Final Step - File Uploads
Upload Paystubs (2 most recent)
Drop files here or

Accepted file types: jpg, png, gif, tif, pdf.
Please upload two of your most recent pay stubs or if you are self employed/1099 a copy of your most current tax returns and something showing your year to date income.
Upload a Copy of Applicant Drivers License
Accepted file types: jpg, png, gif, tif, pdf.
Upload a Copy of Applicant Social Security Card
Accepted file types: jpg, png, gif, tif, pdf.
Phone
This field is for validation purposes and should be left unchanged.