RA

Rental Application

Below is the application for Clinch-Powell's rental properties. PLEASE READ ALL INSTRUCTIONS! Please note that we do NOT provide emergency housing or emergency housing funds. Your application can only be considered after we have ALL of the items listed—including the application fee. To help make the application process easier, a list of FAQ’s & helpful information is on theback of this letter. After the completed application is returned, applicants are considered on a first come, first serve basis. *también disponible en Español
- Completed Rental Application. Please completely fill out application & follow ALL directions!
- Proof of household income of all adults, from ALL sources (i.e. pay stubs, food stamps, award letters, etc.)
  - While we only need 1 copy of an award letter, we need copies of 4+ paychecks to determine an average.
  - IF you have a Section 8 Voucher (rental assistance): provide a copy of a form/letter from the provider that shows the amount/size of your voucher
- From EVERY member of the household, at least 2 forms of ID:
  - Copies of Social Security Cards or other proof of citizenship
  - Copies of Driver's Licenses or State IDs
  - Copies of Birth Certificates for children
- Application Fee of $15.00 PER ADULT.
* Listings and specifics of Clinch-Powell’s policies relating to rental properties and Tenant Selection Criterion can be accessed through the agency’s website: www.clinchpowell.net .

*If you would like more information about a specific property, you can also check: http://www.tnhousingsearch.org/

If left incomplete, this application will expire 30 days from date of receipt.

If you need assistance in completing this application, please contact our office and a staff person will make arrangements to try to assist you.

You may also send questions by e-mail to suzie@clinchpowell.net .
APPLICANT INFORMATION

ALL ADULTS in the household must complete either Applicant or Co-Applicant information. If there are 3 or more adults in the household, contact us for instructions.
First Name*
First Name
Last Name*
Last Name
Property or Area of Interest*
Ex: Morristown, TN, Main St, etc.
Birth Date*

MonthDayYear
License #*
Social Security #*
Primary Phone Number*

Area CodePhone Number
Primary E-mail*
Best time and way to reach you?
Ex: Phone after 3 pm
Will there be another adult on the application? For the purposes of this application, they will need to fill out their information, as well.*

YesNo
Co-Applicant First Name
First Name
Co-Applicant Last Name
Last Name
Birth Date

MonthDayYear
License #
Social Security #
Primary Phone Number

Area CodePhone Number
Primary E-mail
Is anyone in the household self-employed?:*

NoYes
Describe the self employment:

RENTAL HISTORY

We must have your rental history for the last 10 years. Please add additional history using prompts below.
Present Address*

PO Box / Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Present Landlord Name*
Phone Number*

Area CodePhone Number
May we contact this person?*

YesNo
Date moved in:*

MonthDayYear
Date
Expected date to move out:*

MonthDayYear
Date
Rent Amount*
Ex: $450
Reason for Leaving?*
EX: Moving out of parents home, job transfer, etc.
- Previous Address 1
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
- Previous Landlord Name
- Phone Number
  
  Area CodePhone Number
- Dates lived there:
  EX: May 2016 - March 2017
- Previous Address 2
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Previous Landlord Name
- Phone Number
  
  Area CodePhone Number
- Dates lived there:
  EX: May 2016 - March 2017
- Previous Address 3
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Previous Landlord Name
- Phone Number
  
  Area CodePhone Number
- Dates lived there:
  EX: May 2016 - March 2017

EMPLOYMENT INFORMATION

Please provide employment history for the past 2 yrs. If you currently have a second job, put this information in the Previous Employer section.
Are you currently employed?*

YesNo
Present Employer
Position Title
Present Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Phone Number

Area CodePhone Number
Start Date

MonthDayYear
Date
Employment Status
Pay Period Frequency
Gross Pay Period Estimate
Income per check before taxes
- Type of Additional Employer
- Previous Employer/ Second Job
- Position Title
- Previous Employer / Second Job Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Employer Phone Number
  
  Area CodePhone Number
- Dates Employed
  EX: March 2017- May 2018
- Employment Status
- Pay Period Frequency
- Gross Pay Period Estimate
  Income per check before taxes
- Is the Co-Applicant currently employed?
  
  YesNo
- Present Employer
- Position Title
- Present Employer Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Employer Phone Number
  
  Area CodePhone Number
- Start Date
  
  MonthDayYear
  Date
- Employment Status
- Pay Period Frequency
- Gross Pay Period Estimate
  Income per check before taxes
- Type of Additional Employer
- Previous Employer/ Second Job
- Position Title
- Previous Employer / Second Job Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Employer Phone Number
  
  Area CodePhone Number
- Dates Employed
  EX: March 2017 - May 2018
- Employment Status
- Pay Period Frequency
- Gross Pay Period Estimate
  Income per check before taxes

PERSONAL REFERENCES

Only list references NOT RELATED to you.
First Reference*

First NameLast Name
Phone Number*

Area CodePhone Number
Second Reference*

First NameLast Name
Phone Number*

Area CodePhone Number

Background Information

*As a part of the tenant selection process, we will be conducting a background check. The following questions are optional, and will not be counted against you if you choose not to answer.
Has any adult in the household been convicted of a crime within the last 10 years?

YesNo
If yes, please explain:
Specifically, has anyone in the household been convicted of: A) felony larceny, theft, fraud, or forgery; B) money laundering; or C) tax evasion- within the last 10 years?

YesNo
If yes, explain:
Is anyone in the household currently on parole or probation?

YesNo
If yes, please provide the contact information for Parole or Probation Officer:
Have you or the co-applicant ever been evicted or issued a Detainer Warrant?

YesNo
If yes, when? Explain.

Rental Application

APPLICANT INFORMATION

Household Information

RENTAL HISTORY

EMPLOYMENT INFORMATION

Other Houshehold Income

PERSONAL REFERENCES

Background Information

ELECTRONIC SIGNATURE