Long Term Rental Application Form

The main person I have been working with at Weichert, Realtors-Donahue Partners (the person who should receive this application) is:

Please Select Kerry Houde Dana Evans Dennis Murphy I don't recall/no one Someone else    
If someone else, please put his/her name here   First Name   Last Name   
The house/apartment I'm applying for is (if you know the address)   Type a label   

Number of Adults (anyone over 18) who will live here   Number   
Number of children (people under 18) who will live here   Number   
Do you have any animals at all who will be at the house (pets, etc)   YES   NO   
If yes, please briefly describe every animal:      

I understand ALL applicants over 18 must fill out this form:   Yes, I understand   No, I do not understand   

I am one of several applicants.The other applicants associated with my application are (leave blank if there are no others):

First Name   Last Name   
First Name   Last Name   
First Name   Last Name   

If there are more than 4 adults on this application please manually add their names here so we can keep the applications all together:      

YOUR CURRENT LIVING SITUATION

Your current landlord   First Name   Last Name   
Your landlord's phone number   Area Code   Phone Number            
Landlord's email address if known   Email            
WRDP has my permission to contact my landlord      YES   NO   
What is your current rent   Number  
How long have you lived there   Number     Please Select years months    
Your primary reason for moving   Type a label   
Secondary reason for moving, if there is one   Type a label   

If you have lived in your current home for less than 2 years, please fill this section out

Who was your most recent past landlord   First Name   Last Name   
What was that address   Street Address   Address Line 2   City   State   Zip   
Your past landlord's phone number   Area Code   Phone Number   
Your past landlord's email   Email   
What was your rent at this location      
How long did you live here:       Please Select Years Months    
WRDP has my permission to contact this past landlord   YES   NO   

If you have lived in the above previous rental for less than 2 years, please also fill this section out

Who was the landlord before the above rental   First Name   Last Name   
What was that address   Street Address   Address Line 2   City   State   Zip   
That landlord's phone number   Area Code   Phone Number   
That past landlord's email   Email   
What was your rent at this location      
How long did you live here:       Please Select Years Months    
WRDP has my permission to contact this past landlord   YES   NO   

YOUR EMPLOYMENT HISTORY

Your current employer   Type a label   
How long have you worked there   Type a label    Please Select years months    
Your yearly income   Type a label   
Your direct supervisor's name   First Name   Last Name   
Supervisor's phone   Area Code   Phone Number   
Supervisor's email   Email   
WRDP has my permission to contact my supervisor listed here   YES   NO   

Do you have a second employer? Or have you been at the above employer for less than 2 years? If so fill this section out

Your second/past employer   Type a label   
When did this employment start   Date   
If it ended, when did it end   Date    
Your yearly income       
Your direct supervisor's name   First Name   Last Name    
Supervisor's phone   Area Code   Phone Number   
Supervisor's email   Email   
WRDP has my permission to contact my supervisor listed here   YES   NO   

Is there an additional employment you want to make us aware of (3rd job, or another previous job etc)   YES   NO   

Past Employer name:   Type a label   
When did this employment start:   Date   
When did this employment end:   Date   
Your yearly income:   Type a label   
Your direct supervisor's name   First Name   Last Name   
Supervisor's phone:   Area Code   Phone Number   
Supervisor's email:   Email   
WRDP has my permission to contact my supervisor listed here:     Please Select YES NO          

Do you have any additional sources of income    YES   NO  

PERSONAL REFERENCES. We prefer three.

WRDP has my permission to contact these personal references
YES   NO    

Personal Reference #1   First Name   Last Name    
phone:   Area Code   Phone Number    
email:   Email   
relationship:   Type a label   

Personal Reference #2   First Name   Last Name   
phone:   Area Code   Phone Number   
email:   Email   
relationship:   Type a label   

Personal Reference #3   First Name   Last Name   
phone:   Area Code   Phone Number   
email:   Email   
relationship:   Type a label   

ALMOST DONE

Have you ever been sued for not paying a bill   YES   NO   
Have you ever claimed bankruptcy   YES   NO             
Have you ever broken a lease   YES   NO   
Forfeited a security deposit for damage   YES   NO   
Received a Notice to Quit for non-payment of rent   YES   NO
Please list all alias (aka) names associated with you:      

Have you ever been found guilty of a felony     Please Select YES NO      
If yes, please briefly explain   Type a label   

Have you ever been brought to court by a landlord or evicted    Please Select YES NO    
If yes, please briefly explain   Type a label   

Have you ever been locked out of an apartment or house by a sheriff    Please Select YES NO  
If yes, please briefly explain   Type a label     

"EQUAL HOUSING OPPORTUNITY"
By signing below, you are submitting an application for a year round or long term rental through Weichert, Realtors-Donahue Partners, and you are at least 18 years old. All information is true, accurate, and complete to the best of the applicants knowledge. All our properties are individually owned and as such, the property owners make the final decision regarding applicants.

All our rentals require a rental deposit equal to one month's rent as soon as your application is tentatively approved. Applicant understands that this initial deposit is refundable and there is no agreement to rent up to and util a lease/tenancy agreement is signed by both the tenant and the landlord.

If the landlord decides to work with you as a possible tenant, you will be required to submit a credit check at your expense, one for every applicant over the age of 18

By signing below, I understand and agree to all of the above, and certify that all of the above is accurate to the best of my knowledge  

Signature