Westcott Properties Rental Application
PERSONAL DATA
Name
*
First Name
Last Name
Drivers Lic. No. & Expiration Date
Phone Number
*
Name of Co-Tenant
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at your present address? Who is your currently landlord and what is their phone number?
What is your current rent? When does it expire?
Previous Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
List two previous address and list landlord name and phone number (Previous landlords can’t be relatives)
Do you have any occupants? If so, how many, what is their relation and how old are they?
*
Any other applicable information that would help us determine your eligibility?
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Occupation
Rows
PRESENT OCCUPATION
PRIOR OCCUPATION
CO-TENANT'S OCCUPATION
Occupation
Employer
Self-employed, doing business as
Business Address
Business Phone
Type of Business
Position held
Name and Title of Supervisor
How long
Monthly Gross Income
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REFERENCES
List Two Rental References with current phone numbers (Cannot be a relative)Type a question
Have you ever filed a petition for bankruptcy?
*
Have you ever been evicted from any tenancy?
*
Have you ever willfully and intentionally refused to pay any rent when due?
*
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I DECLARE THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT, AUTHORIZE ITS VERIFICATION AND THE OBTAINING OF CONSUMER CREDIT REPORT. I agree that Landlord may terminate any agreement entered into in reliance on any misstatement made above.
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