Rental Application – Mill Point Properties

Today's Date

Date of anticipated move in(Required)

Property Address(Required)

Monthly Rent(Required)

Security Deposit

Pet Deposit

Applicant

Full Name of Applicant(Required)

Current Address(Required)

Phone (primary)(Required)

Phone (work)

D.O.B.(Required)

Applicant's Employment

Name of Current Employer

Address

Position

Date Started

Monthly Income

Supervisor's Name

Phone

Name of Previous Employer

Address

Position

Date Started

Monthly Income

Supervisor's Name

Phone

Other Sources of Income

Spouse

Full Name of Spouse

Current Address

Phone (primary)

Phone (work)

D.O.B.

Spouse's Employment

Name of Current Employer

Address

Position

Date Started

Monthly Income

Supervisor's Name

Phone

Name of Previous Employer

Address

Position

Date Started

Monthly Income

Supervisor's Name

Phone

Other Sources of Income

Present Landlord or Mortgage Company

Present Landlord or Mortgage Company(Required)

Phone(Required)

Monthly Rent or Mortgage Payment(Required)

Date of Move-In(Required)

Date of Move-Out(Required)

Previous Landlord or Mortgage Company

Phone

Monthly Rent or Mortgage Payment

Date of Move-In

Date of Move-Out

Personal References

Name(Required)

Phone(Required)

Address(Required)

Name(Required)

Phone(Required)

Address(Required)

Emergency

In case of emergency contact(Required)

Relationship(Required)

Phone(Required)

Occupants

List all occupants(Required)

Pets

Do you have a pet?(Required)

Yes

List any pets: type

breed

weight

age

Vehicles

List vehicles to be parked at premises:(Required)

Hidden

make

model

year

Credit/Criminal History

Bank Name(Required)

Phone(Required)

Address(Required)

List all credit obligations with minimum monthly payment:(Required)

Have any of the occupants listed above ever been:

Convicted of a Felony?(Required)

Yes

Received Deferred Adjudication for a Felony?(Required)

Yes

Been Evicted?(Required)

Yes

Broken a Lease?(Required)

Yes

Declared Bankruptcy?(Required)

Yes

Please explain any YES response

The above listed applicant declares that all statements made in this application are true and complete. Applicant hereby authorizes the National Association of Independent Landlords to verify all of the information in this application and obtain credit reports on the above listed applicant and/or applicantís. If applicant or applicantís spouse has given any false information Landlord is entitled to reject the application, and retain all application fees as liquidated damages for Landlordís time and expenses in processing this application. Applicant shall give the Landlord a nonrefundable application fee to be paid in the amount of $

Name of Applicant

Date

Name of Co-Applicant

Date