Rental Application

RENTAL APPLICATION

Complete One Application Per Adult
Date You Want To Move In

MonthDayYear
Do you have funds to occupy the unit (deposit + 1st months rent)?

YesNo
Preferred subdivision

Park Place - 566 Myrtle AvenueWindy Hill Duplexes - Hwy 70 E
How many bedrooms?

123
First Name*
Middle Name*
Last Name*
Maiden Name
Date of Birth

MonthDayYear
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Email*
example@example.com
Race

WhiteBlack or African AmericanHispanic or LatinoAsianAmerican Indian or Alaskan NativeNative Hawaiian or other Pacific Islander
Marital Status

MarriedSingle
How Long?
Are you, or have you ever been an active member of the military?

YesNo
Present Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How Long at this address?
Reason for leaving?
Rent per month $$$?
Landlord's Name
Landlord's Phone number
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long at this address?
Reason for leaving?
Rent per month $$$?
Landlord's Name
Landlord's Phone Number
Present occupation?
Employer
How long?
Supervisor
Phone Number
Please enter a valid phone number.
Net income per MONTH (take home)
Checking Account: Bank Account #
Have you ever been evicted?

YesNo
If yes, what year and why?
Have you ever been convicted of a felony?

YesNo
If yes, what year and why?
Are you a registered sex offender?

YesNo
Do you smoke?

NoYesInsideOutside
Do you use illegal drugs?

YesNo
Name and ages of each person living with you:
Is anyone in this household on probation?

YesNo
If so, what for?
List all vehicles residing at this home:
Year, Make, Model
Pet: Breed, Pounds, Age
Type a question

MaleFemaleInsideOutside
Pet: Breed, Pounds, Age
Type a question

MaleFemaleInsideOutside
I declare the statements above are true and correct. With this electronic signature, I authorize Windy Hill Properties, LLC to conduct a background check and verify my credit rating, rental history, employment, and references for this rental as they relate to my tenancy and to future rental collections. I understand any falsification on this application will give Park Place Subdivision, and/or Windy Hill Duplexes the right to void this application. Windy Hill Properties, LLC does not discriminate against age, race, sex, religion, disability or national origin.
Signature

Clear
Date

MonthDayYear
Should be Empty:

RENTAL APPLICATION