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SOCIAL SECURITY NO._____________________________DRIVER’S LICENSE ________________________________STATE_______ HOME PHONE___________________________________________ WORK PHONE ____________________________________________ CURRENT RESIDENCE________________________________________ CITY__________________________STATE/ZIP___________ HOW LONG _____________ MONTHLY RENT $__________________ REASON FOR MOVING __________________________________ LANDLORD’S NAME __________________________________ ADDRESS/PHONE____________________________________________ APPLICANT’S EMPLOYER &ADDRESS _______________________________________________________________________________ POSITION_______________________ PHONE____________________________________ MONTHLY INCOME___________________ SUPERVISOR’S NAME______________________________________________ PERIOD OF EMPLOYMENT______________________ SPOUSE/CO-APPLICANT’S NAME__________________________________________________ DATE OF BIRTH__________________ SOCIAL SECURITY NO. __________________________________________ DRIVER’S LICENSE _______________________________ CURRENT RESIDENCE __________________________________________CITY __________________________STATE/ZIP___________ HOME PHONE ___________________WORK PHONE______________
NAME_____________________________________________________ AGE__________ RELATIONSHIP____________________________ NAME_____________________________________________________ AGE__________ RELATIONSHIP____________________________
MAKE________________ MODEL_________________ YEAR________ COLOR__________ TAG NO.________________STATE________
NAME_______________________________________ PHONE___________________________ RELATIONSHIP______________________ ADDRESS_____________________________________________ CITY_______________________________STATE/ZIP________________
A non-refundable processing charge is payable with this application in the amount of $ 35.00. The applicant understands that the processing charge will not be refunded under any circumstances or applied to any monies due lessor. This information is confidential and used only to access EQUIFAX credit services to ascertain the applicant’s status. The undersigned represents that the above statements are true and complete and authorizes verification of information and references given. It is understood that the amount received $_________ as deposit, apart from application fee, will be returned in accordance with state law if applicant is not accepted as a resident. If accepted and subsequently the resident does not move in on lease date, the amount is hereby acknowledged as liquidated damages for non-performances and will be forfeited by the resident as compensation for holding the property off the market.
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