Mid-Kansas Real Estate
Rental application must be completed by each person age 18 or older who will live in the home.
Name
*
First Name
Last Name
Email
*
example@example.com
Your Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Social Security Number
*
Date of Birth
*
Current Landlord’s Name
Current Landlord’s Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Prior Evictions
*
Please Select
Yes
No
Felonies
*
Please Select
Yes
No
Are you employed?
*
Yes
No
Current Employer
Monthly Income
*
Number of Occupants (including children)
*
Do you have pets? If so, please tell us about them.
*
Newest Paystub
*
Browse Files
Drag and drop files here
Choose a file
Just so you know, if you are employed, your application will be automatically denied if you don't upload your newest pay stub. You may take a screenshot or photo of it and upload it here.
Cancel
of
Do you have a bank account?
*
Yes
No
Newest Bank Statement
Browse Files
Drag and drop files here
Choose a file
Just so you know, your application will be automatically denied if you don't upload your bank statement if you have a bank account.
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of
I certify the above is true and correct.
Submit
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