RENTAL APPLICATION

RENTAL APPLICATION
Applicant Name*

First NameLast Name
Co-Applicant Name

First NameLast Name
Date of Birth*

MonthDayYear
Date
Co-Applicant Date of Birth

MonthDayYear
Date
Social Security*
Co-Applicant Social Security
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Co-Applicant Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Please enter a valid phone number.
Co-Applicant Home Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Co-Applicant Cell Phone
Please enter a valid phone number.
Email*
example@example.com
Co-Applicant Email
example@example.com
Name of Landlord*

First NameLast Name
Co-Applicant Name of Landlord

First NameLast Name
Landlord Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Co-Applicant Landlord Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Landlord Telephone #*
Please enter a valid phone number.
Co-Applicant Landlord Telephone #
Please enter a valid phone number.
Reason for Moving*
Co-Applicant Reason for Moving
Name of Employer*
Co-Applicant Name of Employer
Supervisor Name*

First NameLast Name
Co-Applicant Supervisor Name

First NameLast Name
Position*
Co-Applicant Position
Work Phone*
Please enter a valid phone number.
Co-Applicant Work Phone
Please enter a valid phone number.
Annual Salary*
Co-Applicant Annual Salary
How many years/months on the job?*
Co-Applicant How many years/months on the job?
Date to move in*

MonthDayYear
Date
CERTIFICATION & COMMISSION AGREEMENT: I (we) certify that the information in that is provided above is true and correct. We also authorize EXTREME REALTY ASSOCIATES the right to verify it and run CREDIT REPORT for the approval of our application. We agree to pay a brokerage fee of ONE MONTH RENT which is earned when the MEETING OF THE MIND takes place between the landlord and us. It is a violation of the Law to deal with the owner(s) of the unit without the knowledge of the broker to defraud the Real Estate fee.
Upon acceptance of your application, an application fee of $20 will be required for each applicant and co-applicant. Payment can be made via cash, CashApp, Zelle, or other methods if necessary.
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