Rental Application for CCC Lakehouse
1520 4th Street Perry, OK 73077
Name
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First Name
Last Name
Date of Birth
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Email
*
example@example.com
Please list all addresses where you have lived in the past five years, along with the reason you moved from each location.
*
Do you have any pets?
*
Do you smoke or vape?
*
Number of People Who Will Live in the Residence
*
Date you would like to move in
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Gross Income
*
Income Source
*
Social Security Number
*
Driver's License Number
*
AUTHORIZATION TO OBTAIN BACKGROUND, CREDIT, AND OTHER SCREENING INFORMATION
By signing below, I acknowledge and agree to allow the City of Perry to obtain and review my background, credit history, and other relevant screening information as outlined in the Authorization to Obtain Background, Credit, and Other Screening Information section above.I understand that submitting this application does not guarantee approval or an offer to rent the property.I further certify that all information provided in this application is true and complete to the best of my knowledge. I authorize the City of Perry to verify the accuracy of this information, including contacting any listed employers, references, or prior landlords as part of the screening process.
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