Rental Credit Application
Note: A non-refundable $30.00 application fee is required before processing this application.
Please complete all requested information on this form.
APPLICANT'S NAME:____________________________________________________________________________________________
SSN#_____________________________DATE OF BIRTH____________________MARITIAL STATUS___________________________
DRIVER'S LIC. # & STATE ___________________________________________ ________________
HOME PHONE____________________________________________________CELL PHONE__________________________________
CO-APPLICANTS NAME: _________________________________________________________________________________________
SSN#____________________________DATE OF BIRTH_____________________MARITIAL STATUS___________________________
DRIVER'S LIC.# & STATE ____________________________________________ __________________
HOME PHONE____________________________________________________CELL PHONE___________________________________
PRESENT ADDRESS_____________________________________________________________________________________________
HOW LONG____________________________________
PRESENT LANDLORD___________________________________________PHONE#_________________________________________
EMPLOYMENT REFERENCES:
EMPLOYER / ORGANIZATION______________________________________________________________________________________
ADDRESS____________________________________________________PHONE____________________________________________
POSITION______________________________________________HOW LONG?_____________________SALARY__________________
PREVIOUS EMPLOYER____________________________________________________________________________________________
ADDRESS___________________________________________________PHONE______________________________________________
POSITION_____________________________________________HOW LONG?______________________SALARY___________________
CO APPLICANT EMPLOYEE REFERENCES
EMPLOYER / ORGANIZATION_______________________________________________________________________________________
ADDRESS___________________________________________________PHONE______________________________________________
POSITION___________________________________________________SALARY______________________________________________
NAME / ADDRESS / PHONE# OF BANK
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
CREDIT CARD INFORMATION / NAME / TYPE
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
I hereby make application for a rental and certify that this information is correct. I authorize Simmons Rentals to contact any references that I have listed and to run a credit report. If applicant is approved and the propertyis taken off the market, the security / damage deposit will be forfeighted should the applicant not lease the property.
APPLICANT'S SIGNATURE_________________________________________________________________________DATE______________
CO-APPLICANT'S SIGNATURE______________________________________________________________________DATE______________
LIST ALL PERSONS TO OCCUPY PROPERTY:________________________________________________________AGE________________
_______________________________________________________________________________________________AGE________________
_______________________________________________________________________________________________AGE________________
Please fill out in full and sign.
