Cyndy Rents Houses

Rental Application

Important!!

Each adult (18 and over) must fill out a separate application!

Please fill out as much information as you can.

Fields with a * are required. If a field does not apply, enter n/a or 0.

Remember, the more complete this application is the better we can serve you.

Rental Application

House or Apartment I am Applying for:
Address*
Personal Information
Name*
First Last
Birth Date
Month
Day
Year
Driver's License #*
Phone*
Email*
All other proposed occupants: Name, age, relationship to applicant*
Rental/Residency History
Current Address*
Street Address City
Owner/manager Name*
Owner/manager Phone*
Reason for wanting to move*
Have you given notice yet?*
- Yes
- No
Been at present location since*
Month
Day
Year
Previous Address*
Street Address City State
Owner/manager Name & Phone #
Dates of Residency*
Employment History
Current Employer*
Company Address
Phone*
Name of Supervisor*
Occupation*
Gross Monthly Pay*
Employed since*
Month
Day
Year
Previous Employer
Company Address City
Phone
Name of Supervisor
Occupation
Gross Monthly Pay
Dates of Employment
Credit History
Checking Account: Bank*
Checking Account: Balance*
Savings Account: Bank*
Savings Account: Balance*
Credit Card: Bank*
Credit Card: Balance*
Credit Card 2: Bank
Credit Card 2: Balance
Auto Loan: Bank*
Auto Loan: Balance*
Auto Loan 2: Bank
Auto Loan 2: Balance
If you are applying for one of our rent to own homes, much do you have for a down payment?*
Vehicles
Make, Model, Year and License Plate Number*
Vehicle 2: Make, Model, Year and License Plate Number
References and Emergency Contacts
By signing this application you grant us permission to communicate with all the contacts listed in this section in the event we can not locate you. Furthermore, if you abandon the premises for any reason then you grant us permission to allow your relative listed below to remove all contents of the dwelling on your behalf.
Doctor
Name City
Phone
Lawyer
Name
Address
City
Phone
Relatives
Relative 1 and Relationship*
Name City State
Phone*
Relative 2 and Relationship
Name City State
Phone
General Information
How long do you think you would be renting from us?*
When would you be able to move in?*
How many animals do you have? List types and approx weight.*
Do any of the people who would be living in the premises smoke?*
- Yes
- No
Have you ever been Evicted?*
- No
- Yes
Have you ever files for bankruptcy? If so, when.*
Have you ever been convicted of a felony?*
- No
- Yes
If yes explain
List any verifiable sources of income you would like us to consider (optional).
If you were to run into financial difficulty in the future and couldn't come up with the money to pay the rent, do you know someone who would loan you the money? If so, provide their information so we can use them as a reference for you.
Name and Relationship Address City State / Province / Region ZIP / Postal Code
Phone
Is there anything else you would like us to know?
Agreement and Authorization Signature
I believe the statements I have made are true and correct. I hereby authorize a credit check to be made, verification of information I provided and communication with any and all names listed on this application. I understand that this is a rental application only for an apartment/house and does not constitute a rental or lease agreement in part or whole. Any questions regarding rejected applications must be submitted in writing to Manager, PO Box 349, Dublin, PA 18917.*

Type you name and initials as your signature.
Date*
MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

We respect your privacy. See our privacy policy.

Cyndy Rents Houses

Rental Application

Important!!

Each adult (18 and over) must fill out a separate application!

Please fill out as much information as you can.

Fields with a * are required. If a field does not apply, enter n/a or 0.

Remember, the more complete this application is the better we can serve you.

Rental Application

House or Apartment I am Applying for:

Personal Information

Rental/Residency History

Employment History

Credit History

Vehicles

References and Emergency Contacts

Doctor

Lawyer

Relatives

General Information

Agreement and Authorization Signature