Countdown Properties Rental Application

DESIRED MOVE-IN DATE*

MonthDayYear
Date
RENTAL LOCATION*
PRIMARY APPLICANT INFORMATION

MUST BE 18 YEARS OLD TO APPLY.
PRIMARY APPLICANT*

First NameLast Name
DATE OF BIRTH*

MonthDayYear
SSN*
PHONE NUMBER*
EMAIL*
DRIVER'S LICENSE #
CURRENT ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?*
LANDLORD NAME
LANDLORD PHONE
PREVIOUS ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?*
LANDLORD NAME
LANDLORD PHONE
Other occupants

ONLY 1-2 RESIDENTS PER UNIT, UNLESS APPROVED BY PROPERTY MANAGEMENT. ADDITIONAL FEES MAY APPLY.

COMPLETE THE FOLLOWING INFORMATION FOR ADDITIONAL OCCUPANTS

	FIRST NAME	LAST NAME	DATE OF BIRTH
1
2

PETS

PETS MUST BE APPROVED AND MUST NOT EXCEED 40LBS (FEES APPLY). NO MORE THAN 2 PETS PER UNIT.

COMPLETE THE FOLLOWING INFORMATION FOR ADDITIONAL OCCUPANTS

	TYPE OF PET	WEIGHT
1
2

EMPLOYMENT & INCOME INFORMATION
CURRENT EMPLOYER*
OCCUPATION/POSITION*
DATE HIRED*

MonthDayYear
MONTHLY SALARY*
SUPERVISOR NAME*
PHONE NUMBER*
ADDITIONAL EMPLOYER
OCCUPATION/POSITION
DATE HIRED

MonthDayYear
MONTHLY SALARY
SUPERVISOR NAME
PHONE NUMBER
PERSONAL REFERENCES
NAME

First NameLast Name
PHONE #
RELATIONSHIP
NAME

First NameLast Name
PHONE #
RELATIONSHIP
BACKGROUND INFORMATION
HAVE YOU (OR OTHER OCCUPANT) BEEN CONVICTED OF A CRIME? IF YES, PLEASE PROVIDE TYPE OF OFFENSE, COUNTY AND STATE. *
HAVE YOU (OR OTHER OCCUPANT) BEEN EVICTED FROM A TENANCY OR LEFT OWING MONEY? IF YES, PLEASE PROVIDE PROPERTY NAME, CITY, STATE AND LANDLORD NAME.*
VEHICLE INFORMATION
MAKE & MODEL
YEAR
LICENSE NO. & STATE
OTHER VEHICLES
BANKING INFORMATION
FINANCIAL INSTITUTION
ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
APPLICANT STATEMENT AND SIGNATURE
I declare that the information provided in this application is accurate.

I authorize Countdown Properties to obtain an investigative consumer credit report (including but not limited to credit history, criminal record search, registered sex offender search). This investigation will be for resident screening purposes only and will remain strictly confidential.

I authorize Countdown Properties to contact the references listed in this application.
SIGNATURE*

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DATE*

MonthDayYear
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