Affordable Rental Properties Application

Company Name*

Full Name*

First NameLast Name

Birth Date

MonthDayYear

Social Security Number*

xxx-xx-xxxx

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Length of time at current address*

E-mail*

Phone Number*

Area CodePhone Number

Secondary Phone Number

Area CodePhone Number

Upload your Federal Issued License or ID*

Browse Files

Landlord Full Name*

First NameLast Name

Landlord Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current Rent Amount*

Landlord Contact Number

Area CodePhone Number

List Reason for Moving*

Your Prior Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Prior Landlord's Name*

First NameLast Name

Prior Landlord's Phone Number*

Area CodePhone Number

Prior Rent Amount*

List Reason for Moving*

Sources of Income*

Are you currently employed?*

YesNo

Current Employer*

Position*

Length of Employment*

Monthly Salary*

Annual Income*

Supervisor Name*

Business Phone Number*

Area CodePhone Number

Prior Employer*

Position*

Supervisor Name*

Length of Employment*

Annual Income*

Business Phone Number*

Area CodePhone Number

Nearest Relative Not Living With You*

First NameLast Name

Relative Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Relative Phone Number*

Area CodePhone Number

Relationship*

Financial Institution Name #1*

Branch*

Account Number*

Financial Institution Name #2*

Branch*

Account Number*

Do you own Real Estate*

YesNo

If "yes" you own Real Estate, please explain where*

Have you ever been evicted from any rental Premises?*

YesNo

If yes, please explain: *

Have you ever willfully and intentionally refused to pay rent when due?*

YesNo

If yes, please explain: *

Are there any circumstances which may interrupt your income or ability to pay rent?*

YesNo

If yes, please explain: *

Have you ever been convicted of a felony? (Will not necessarily cause your application to be denied).*

YesNo

If yes, please explain: *

By submitting this application you agree: I represent that the information provided in this Application is true and correct to the best of my knowledge. 4242 Government LLC is authorized to verify the references and employment information given in this Application and to request a credit check. A credit check will not automatically disqualify a tenant. Additional security deposit may be required.

Confirm*

I Agree

Applicant Signature*

Date*

Date

Enter the message as it's shown*

IT IS AGAINST THE LAW TO DISCRIMINATE AGAINST PROSPECTIVE TENANTS ON
THE BASIS OF RACE, RELIGION, NATIONAL ORIGIN, AGE, DISABILITY OR FAMILY
STATUS. LOCAL OR STATE LAWS MAY INCLUDE ADDITIONAL CLASSES WHICH
ARE PROTECTED FROM DISCRIMINATION IN HOUSING.

The information provided by the prospective tenant(s) may be used by 4242 Government LLC to determine whether to accept this Application. Upon written request within 60 days, 4242 Government LLC will disclose to the Applicant in writing the nature and scope of any investigation 4242 Government LLC has requested, and will, if the Application is refused, state in writing the reason for said refusal.

Affordable Rental Properties, LLC

Applicant Information

Sources of Income and Employment Section

Bank References