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.

    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

    Spouse’s Signature

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