Online Rental Application

Address of Property You're Applying for*

Street Address and Apartment Number

Desired Move In Date*

Date

I am applying as a*

Tenant. (I will be living on the property.)Guarantor/co-signer for another applicant. (I will not be living on the property.)

Legal Full Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Birth Date*

MonthDayYear

Social security number *

Photo ID *

Browse Files

OCCUPANTS

Total Number of Adults (Over 18)*

Total Number of Children (Under 18)*

Adult Names

Children Names

Do You Own a Support Animal / Pet?*

YesNo

Please Provide At Least 3 Years of Residental History

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Monthly Rent Amount*

Landlord*

Landlord's Phone Number*

Area CodePhone Number

Landlord's Email Address*

Resided From*

Date

To*

Date

Is rent up to date?*

YesNo

If not, how delinquent are you?

Number of Days, Months

Have You Given Notice?*

YesNo

Reason For Leaving? *

Provide Your Previous Address Histroy

Previous Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Monthly Rent Amount*

Landlord*

Landlord's Phone Number*

Area CodePhone Number

Landlord's Email Address*

Resided From*

Date

To*

Date

Employment / Income Information

Are you currently employed?*

YesNo

Current Employer*

Employment Status*

Position Held*

Employer's Telephone Number*

From*

Start Date

To

Date

Gross Weekly Income*

Supervisor*

Proof of Income*

Browse Files

(e.g. recent pay stubs, bank statements, or tax returns)

If Student, List School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Expected Date of Graduation

PREVIOUS EMPLOYER

Previous Employer

Position Held

Employer's Telephone Number

From*

Start Date

To

Date

Gross Weekly Income

Supervisor

OTHER INCOME

Social Security/ SSI

$ Amount per Month

VA Pension

$ Amount per Month

School Loans

$ Amount per Month

Alimony

$ Amount per Month

Child Support

$ Amount per Month

Public Assistance

$ Amount per Month

Other Income not listed

Name Income and $ Amount per Month

Please describe all pets

VEHICLE INFORMATION

Do you own a vehcile?*

YesNo

Make

Model

Year

State, License Plate #

Lein Holder

REFERENCES

Name of Parent or Next of Kin

Telephone Number

Relationship

Name of Non - Relative Reference

Telephone Number

Name of Non - Relative Reference

Telephone Number

Have you ever been convicted of a felony?*

YesNo

Have you ever filed bankruptcy?*

YesNo

Do you have a judgment against you?*

YesNo

Have you ever broken a lease?*

YesNo

Have you ever been sued for eviction?*

YesNo

Have you ever been sued for bills?*

YesNo

Do you have a water bed, an aquarium or any other water filled furniture?*

YesNo

If you answered yes to any of these questions, please explain:

Name in which utilities are now billed

Utility Account Number

By submitting this application you agree:

1) The information provided herein is complete and accurate. Providing incomplete and/or false information could result in the rejection of the application.

2) This application must be signed before the Landlord can consider it. Acceptance of this application, and any monies deposited herewith, is not binding upon Landlord until approved by Landlord.

3) By singing this application, I fully understand that a credit report may be taken. By signing, the applicant(s) recognizes that the Landlord and/or his agent may investigate the infomration supplied by the applicant(s) and a full disclosure of pertinent facts may be made to the Landlord.

4) Applicant(s) authorizes the owner to contact past and present landlords, employers, creditors, credit bureau, neighbors and any other sources deemed necessary to investigate the applicant(s). ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM OR A PHOTOCOPY OF THIS FOR AT ANY TIME.

5) Additional information may be required in order to process your application. Our management team will contact you upon receipt of this online application to obtain any additional information necessary to complete the processing of your application.

Confirm*

I Agree and Understand

Signature*

Michael Racine Properties