Pinnacle Rental Application
Complete this form to apply for a Pinnacle property. Please provide accurate information in all required sections.
Applicant Information
Full Name (include all names you use or have used)
*
Home Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Vehicle Information
Vehicle Make
Vehicle Model
Vehicle Color
Vehicle Year
License Plate Number/State
Additional Occupants
Additional Occupant 1 - Full Name
Additional Occupant 1 - Relationship to Applicant
Additional Occupant 2 - Full Name
Additional Occupant 2 - Relationship to Applicant
Additional Occupant 3 - Full Name
Additional Occupant 3 - Relationship to Applicant
Residence History
Current Address - Street/Unit
*
Current Address - City/State/ZIP
*
Dates Lived at Address
Reason for Leaving
Landlord/Manager Name
Landlord/Manager's Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Current Rent
Current Security Deposit
Employment and Income
Current Employer - Name
Current Employer - Address Line 1
Current Employer - Address Line 2
Current Employer Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor Name
Supervisor Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Dates Employed at This Job
Position or Title
Gross Monthly Employment Income (before deductions)
Average Monthly Amounts of Other Income - Amount
Average Monthly Amounts of Other Income - Sources Description
Total Monthly Income
Bank Accounts
Savings Account - Account Number (or N/A)
Savings Account - Bank/Institution
Savings Account - Branch
Checking Account - Account Number (or N/A)
Checking Account - Bank/Institution
Checking Account - Branch
Major Credit Card
Major Credit Card Type
VISA
MC
Discover Card
Am Ex
Other
Major Credit Card - Issuer
Major Credit Card - Account No. (last 4 digits)
Major Credit Card - Balance
Major Credit Card - Average Monthly Payment
Loans and Major Obligations
Loan 1 - Type of Loan
Loan 1 - Name of Creditor
Loan 1 - Account Number (last 4 digits)
Loan 1 - Amount Owed
Loan 1 - Monthly Payment
Loan 2 - Type of Loan
Loan 2 - Name of Creditor
Loan 2 - Account Number (last 4 digits)
Loan 2 - Amount Owed
Loan 2 - Monthly Payment
Loan 3 - Type of Loan
Loan 3 - Name of Creditor
Loan 3 - Account Number (last 4 digits)
Loan 3 - Amount Owed
Loan 3 - Monthly Payment
Other Major Obligation 1 - Type
Other Major Obligation 1 - Payee
Other Major Obligation 1 - Amount Owed
Other Major Obligation 1 - Monthly Payment
Other Major Obligation 2 - Type
Other Major Obligation 2 - Payee
Other Major Obligation 2 - Amount Owed
Other Major Obligation 2 - Monthly Payment
Pets and Special Items
Number and Type of Pets
Water-filled Furniture Description
Background Information
Do you smoke?
Yes
No
Filed for bankruptcy?
Yes
No
Filed for bankruptcy? - How many times
Been sued?
Yes
No
Been sued? - How many times
Sued someone else?
Yes
No
Sued someone else? - How many times
Been evicted?
Yes
No
Been evicted? - How many times
Been convicted of a crime?
Yes
No
Been convicted of a crime? - How many times
Explain any "yes" listed above
References and Emergency Contact
Personal Reference 1 - Name
Personal Reference 1 - Relationship
Personal Reference 1 - Address Line 1
Personal Reference 1 - Address Line 2
Personal Reference 1 - Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Personal Reference 2 - Name
Personal Reference 2 - Relationship
Personal Reference 2 - Address Line 1
Personal Reference 2 - Address Line 2
Personal Reference 2 - Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact - Name
Emergency Contact - Relationship
Emergency Contact - Address Line 1
Emergency Contact - Address Line 2
Emergency Contact - Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Source
Where did you learn of this vacancy?
Authorization and Signature
Applicant Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Application
Submit Application
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