---
title: "Application to Lease"
description: "Application to Lease Please complete the form below. You can sign with a Digital Signature and submit it. Alternatively, you can download the form by clicking on the document icon on the right, then p..."
url: https://reliableproperties.com/application-to-lease/
date: 2017-02-16
modified: 2022-06-30
author: "bonnie mckinney"
type: page
lang: en
---

# Application to Lease

# Application to Lease

---

###### Please complete the form below. You can sign with a Digital Signature and submit it. Alternatively, you can download the form by clicking on the document icon on the right, then print, sign, scan and email or fax it.

[Click here to download](http://reliableproperties.com/wp-content/uploads/retail_applicationtolease.pdf)

## **APPLICATION TO LEASE**

| **Applicant’s Name** | |
| --- | --- |
| **Email** | | **Cellphone #** | | **Birthdate** | |
| **Soc. Sec. No.** | | **Driver’s Lic No.** | | **State** | |

**CASH IN HAND & ALL CHECKING & SAVINGS BANK ACCOUNTS** (Provide copy of most recent statement)

| | Name of Bank | Cash Balance | Address of Bank | Account No. |
| --- | --- | --- | --- | --- |
| 1. | | | | |
| 2. | | | | |
| 3. | | | | |
| 4. | | | | |
| 5. | | | | |

**Real Estate**

| | **Property #1** | **Property #2** |
| --- | --- | --- |
| Property Address  | | |
| Title, in whose name  | | |
| Current Market Value (approx.)  | | |
| Current Balance of First Loan  | | |
| Monthly Payment – 1st Loan  | | |
| Lender’s Name | | |
| Lender’s Telephone No.  | | |
| Loan Number  | | |
| Current Balance of Second Loan | | |
| Monthly Payment – 2nd Loan  | | |
| Lender’s Name  | | |
| Lender’s Telephone No.  | | |
| Loan Number  | | |

**Trade References (Where you buy from):**

| 1) | |
| --- | --- |
| | | | | | |
| 2) | |
| | | | | | |

**PERSONAL REFERENCES: **(Relatives & Friends):

| | **Name** | **Address** | **Phone No. Cell & Home** | **Occupation** | **Relationship** | **Yrs. Known** |
| --- | --- | --- | --- | --- | --- | --- |
| 1. | | | | | | |
| 2. | | | | | | |
| 3. | | | | | | |
| 4. | | | | | | |

**RESIDENCE:**

| Present Address: | |
| --- | --- |
| Own | | Rent | | | How Long? | | |
| Previous Address: (If less than 5 years) | |
| If Rent: | |

| **MONTHLY INCOME (average)** | **MONTHLY PAYMENTS (average) ** |
| --- | --- |
| Salary and/or Fees received | | Loan Payments | |
| Bonus & Commissions | | Rent/Lease | |
| Dividends & Interest | | Taxes (income & property taxes) | |
| Real Estate Net Income | | Living Expenses | |
| Business Royalty Income | | Guarantor Obligations | |
| Other Income | | Unsatisfied Legal Claims/Judgment | |
| | | Liability as an endorser or co-maker of notes | |
| | | Other liabilities (alimony, child support, maintenance, etc.) | |
| | | | |
| | | | |
| **TOTAL MONTHLY GROSS INCOME** | | **TOTAL MONTHLY EXPENSES** | |

**AUTOMOBILES**

| | Make | Model | Color | Year | License Number | Current Value | Financed / Leased By | Telephone Number | Loan Number | Amount Owing | Monthly Payment |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. | | | | | | | | | | | |
| 2. | | | | | | | | | | | |

**ACCOUNTS AND NOTES RECEIVABLE **

| | Name, Address and Phone # of Debtor | Maturity Date | Face Value | Monthly Installment Payments | Balance Due | Description of Security |
| --- | --- | --- | --- | --- | --- | --- |
| 1. | | | | | | |
| 2. | | | | | | |
| 3. | | | | | | |

**MARITAL STATUS:**

| MarriedDivorcedSingleSeparatedWidowed | If married, please provide the following: |
| --- | --- |
| Spouse’s Name | | | | |
| Birthdate | | Soc. Sec. No. | | Driver’s Lic. No. | |
| Spouse’s Employer | | Employed for how long? | |
| | | | | |

**STOCKS, BONDS & SECURITIES**

| | Name of Stock Certificate Holding Company | Account Number | Address | Approx. Current Total Market Value |
| --- | --- | --- | --- | --- |
| 1. | | | | |
| 2. | | | | |
| 3. | | | | |

**BUSINESS:**

| Are You: | Relocating?Expanding?Starting a new business? |
| --- | --- |
| Name of Current Business | | Type of Business | |
| Is it: | CorporationPartnershipSole Ownership | (PLEASE PROVIDE COPY OF CURRENT BUSINESS LICENSE) |
| | | | | |
| How long in business? | | Gross Monthly Income | |
| Landlord | | | | | |
| Proposed business at this location | | Address of space desired: | |
| Detailed description of business/services to be provided: | |
| |
| List names of all major owners/directors of the organization: |
| | | |

| Have you ever filed for bankruptcy (under Chapter 7, 11 or 13) either personally or as a partial owner of an entity? | NoYes |
| --- | --- |
| If yes, please explain: | |
| |
| A) Are you a defendant in any legal action? | YesNo | B) Are there any unsatisfied judgments? | YesNo |
| Have you ever been charged or convicted of a misdemeanor, felony or criminal charge, or pleaded nolo contendere to any charge, or been held liable in a civil action by final judgment, or been the subject of a material complaint or other legal proceedings? Have you ever been charged with civil action, complaint, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations? | YesNo |
| If yes, please explain: | |
| |

**PRESENT EMPLOYMENT:**

| Employer/Company | | Self Employed: | YesNo |
| --- | --- | --- | --- |
| Company Address | | Phone No. | |
| Length of Employment/Ownership | | Job Title (if applicable) | | Monthly Gross Income | |
| PLEASE PROVIDE THE FOLLOWING DOCUMENTS: |
| 1.) Copies of personal Tax returns of all principals for the last 2 years (and if applicable, company Tax returns) |
| 2.) Current personal and/or company financial statements with last 2 months bank statements, checking and savings |
| 3.) Copy of any professional licenses |
| 4.) Copy of current business license |
| 5.) Copy of current driver license |

**EDUCATION: **

| Select the last year of school completed: |
| --- |
| High School: | 9101112 | College: | 1234 | Graduate School: | 123456 |
| College/Graduate School | | Degree & Year Graduated | |

In case of emergency, notify:

| 1) Name | | Address | | Phone: | |
| --- | --- | --- | --- | --- | --- |
| | | | | | |
| | | | | | |
| 2) Name | | Address | | Phone: | |
| | | | | | |
| | | | | | |
| I certify that the answers given on this application are true and correct and that I have withheld nothing that would, if disclosed, affect this application. I understand that investigative background inquiries are to be made on myself and my spouse, including consumer credit, driving, civil, criminal, bank statements and verification of deposits and other reports, including various federal, state and other agencies which maintain records concerning our past activities relating to our background. These reports will include information about me and my spouse and our financial information. I authorize release of any information deemed necessary by Landlord and its designated representative(s), at anytime to verify the enclosed information contained or any additional information required. |
| **Applicant’s Signature** - [Draw It](#5)
- [Type It](#6) | **Spouse’s Signature** - [Draw It](#7)
- [Type It](#8) |
| I agree that this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature. |
| Enter the code in the box below: |
| ![captcha](https://reliableproperties.com/wp-content/uploads/wpcf7_captcha/2775486310.png) |
| |