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Application for Rental
All Adults Residing in Property Must Fill Out a Separate Application
Personal Information
Applicant Name
*
First Name
Middle Name
Last Name
Cell Phone Number
*
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Social Security Number
*
Driver's License Number
*
Driver's License State of Issue
*
*
Married
Unmarried
Desired Date of Occupancy
*
-
Month
-
Day
Year
Date
Residence History
Present Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Rent/Mortgage Payment
*
How Long at Present Address?
*
Present Address-
*
Rent
Own
Present Landlord/Agent Name
Present Landlord/Agent Phone Number
-
Area Code
Phone Number
Previous Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Previous Rent/Mortgage Payment
How Long at Previous Address?
Previous Address-
Rent
Own
Previous Landlord/Agent Name
Previous Landlord/Agent Phone Number
-
Area Code
Phone Number
Employment History
Employer Name
*
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Name
First Name
Last Name
Supervisor Phone Number
-
Area Code
Phone Number
Length of Employment
*
Position Title
*
Gross Monthly Pay
*
Other Income - Amount Per Month
Other Income Source(s)
Previous Employer - COMPLETE ONLY IF YOU HAVE BEEN WITH YOUR CURRENT EMPLOYER FOR LESS THAN ONE YEAR
Employer Name
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Name
First Name
Last Name
Supervisor Phone Number
-
Area Code
Phone Number
Length of Employment
Position Title
Gross Monthly Pay
Emergency Contacts - You authorize emergency contacts listed to enter and take possession of your personal property in the event of death, disability or incarceration, pursuant to A.R.S.§33-1314(F)
Emergency Contact #1
*
First Name
Last Name
Emergency Contact #1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact #1 Phone Number
*
-
Area Code
Phone Number
Emergency Contact #1 Email
example@example.com
Emergency Contact #2
*
First Name
Last Name
Emergency Contact #2 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact #2 Phone Number
*
-
Area Code
Phone Number
Emergency Contact #2 Email
example@example.com
Nearest Relatives Not Living With You
Relative #1
*
First Name
Last Name
Relative #1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relative #1 Phone Number
*
-
Area Code
Phone Number
Relative #1 Email
example@example.com
Relative #2
First Name
Last Name
Relative #2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relative #2 Phone Number
-
Area Code
Phone Number
Relative #2 Email
example@example.com
Other Persons Who Will Occupy The Property
Person #1
First Name
Last Name
Person #1 Relationship
Person #1 Age
Person #2
First Name
Last Name
Person #2 Relationship
Person #2 Age
Person #3
First Name
Last Name
Person #3 Relationship
Person #3 Age
Person #3
First Name
Last Name
Person #4 Relationship
Person #4 Age
Person #5
First Name
Last Name
Person #5 Relationship
Person #5 Age
Vehicle Information
Vehicle #1 Make AND Model
*
Vehicle #1 Year
*
Vehicle #1 Color
*
Vehicle #1 License Plate Number
*
Vehicle #2 Make AND Model
Vehicle #2 Year
Vehicle #2 Color
Vehicle #2 License Plate Number
Pet Animals
Will You Have Pet(s)?
*
Yes
No
Pet #1 Breed
Pet #1 Weight
Pet #1 Age
Pet #2 Breed
Pet #2 Weight
Pet #2 Age
Pet #3 Breed
Pet #3 Weight
Pet #3 Age
Questions
Have you ever been evicted or asked to move?
*
Yes
No
Have you ever filed for bankruptcy?
*
Yes
No
Have you had two (2) or more late rental payments in the past year?
*
Yes
No
Have you ever willfully or intentionally refused to pay rent when due?
*
Yes
No
Do you currently owe any monies to an apartment community or landlord?
*
Yes
No
Do you use any illegal drugs?
*
Yes
No
Have you ever engaged in the distribution or sale of illegal drugs?
*
Yes
No
Do you have any outstanding warrants or anticipate any warrants for arrest?
*
Yes
No
For any questions answered 'Yes' above, please give a detailed explanation(s), date(s), and name(s), etc.
Signature
CORRECT INFORMATION – Applicant represents that the above statements are true and complete and hereby authorizes verification of any or all information, references and credit records. In addition to the foregoing, applicant(s) has (have) paid the landlord herein the sum of $30.00 as a non-refundable fee for the landlord’s cost and expense in checking applicants credit application. Applicant acknowledges that false information herein may constitute grounds for rejection of this application and/or termination of occupancy and/or forfeiture of deposits and may constitute criminal offense under the laws of the State of Arizona. AUTHORIZATION FOR FILE DISCLOSURE– I hereby authorize Sierrita Properties, LLC to obtain a consumer credit report and/or investigation report on myself consisting of, but not limited to, employment verification, motor vehicle records, criminal scan, bad check and driver’s license verification for the purpose of renting with the above mentioned company. I understand that such information may be derived in whole or in part from Experian, Equifax, Quest Diagnostics, American Driving Records, Contemporary Information Corporation, and/or other sources. In addition, I authorize any present or past Landlord; Administrator; present and/or past Employers; Private Business; Personal Reference; and/or other person to give record or information they may have concerning my criminal history; credit history, character and employment history or any other information requested. I voluntarily and knowingly unconditionally release any named or unnamed informant from any and all liability resulting from the furnishing of this information. This authorization shall be valid from one year from the date signed and a photographic or faced copy of this authorization shall be as valid as the original. Sierrita Properties, LLC is the agent of the landlord exclusively. Applicant acknowledges that Sierrita Properties, LLC may not be able to complete a comprehensive evaluation of this information prior to move-in. Sierrita Properties, LLC reserves the right to verify application information after move-in and may convert the proposed Rental Agreement to a month-to-month term or declare the lease irreparably breached and seek immediate eviction if false or misleading information is contained in this Application for Residency. This application is preliminary only and does not obligate Sierrita Properties, LLC to execute a lease or deliver possession of this proposed Property. I understand that the $30 fee for verifying this rental application is not a deposit, will not be applied to any rent, or refunded even if the application to rent is declined. Applicant may access the Arizona Department of Real Estate BUYER ADVISORY online to research any concerns with the property or area at HTTP://www.aaronline.com/documents/buyer_advisory.aspx prior to submitting this application.
The applicant authorizes Sierrita Properties, LLC or Horizon Hill Homes, LLC to verify application information including, but not limited to, residence history information. Information given will be used solely for the purpose of rental approval or disapproval.
Signature
*
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