RENTAL APPLICATION R J Beardsley 451-6750 (Voice) 927-0609 (Fax) P O Box 160294 Sacramento, California 95816-0294 Bob@rjbeardsley.com This Application is made to rent premises known as: ____________________________________________ _____________________ _______________________________ for a term of Month to Month rental. Desired date of occupancy: ______________________________________________ Desired length of occupancy: _______________________________________________ Reason for moving? _______________________________________________ ___________________________________________________________________________ The monthly rent shall be $ _________ payable in advance. The following deposits are required: - security deposit Security and cleaning deposit of $_________. - pet deposit of: (negotiatable, $ _________ minimum) An application fee of $30.00 is made with this Application. The application fee reimburses staff for investigation and verification of information submitted to Owner or his representative and will not be returned to the Applicant if the Premises are not rented to the Applicant. If any Deposit monies are accepted in addition to the above fees, only that deposit is refundable and applies to a single applicant. Name:___________________________________________________________ PRESENT ADDRESS:_______________________________________________ How long:________________________________ Home Phone No.:__________________________ Landlord's Name:___________________________________________________ Phone No.:_____________________________ Current rent payment:__________________ No. of occupants: Adults:_____ Children:_____ Water bed? Yes _____ No _____ Smokers? Yes _____ No _____ Pets? Yes _____ No _____ PRIOR ADDRESS:____________________________________________________ How long:___________ Landlord's Name:__________________________________________________ Phone No.:__________________________ Rent payment:_______________________ Reason for moving:_______________________________________________ Social Security Number: _______-______-_______ Driver's License No: _____________________ State: _______________ Vehicle Model:_____________________Year:__________ License No:________________________ Vehicle Model:_____________________Year:__________ License No:________________________ Employer:________________________________________________________ Address:_________________________________________________________ Position:___________________________How long:____________________ Supervisor:_________________________Business Phone:______________ Annual Income:___________________________________________________ Source of Income: Wages $__________ Salary $__________ Commission $__________ Tips $__________ Govt. assistance $__________ Child support/Alimony $__________ Other $__________ PRIOR EMPLOYER:_______________________________________________ Position:_________________________ How long:_________________ Supervisor:_______________________ Business Phone:___________ Annual Income:________________________________________________ NEAREST RELATIVE NOT LIVING WITH YOU: Name:_______________________________________________________ Address:____________________________________________________ Home Phone No.:___________________ Relationship:______________________ Do you own real estate: Yes____ No____ Where?___________________________________________________________ _________________________________________________________________ Have you ever been evicted from any rental premises? Yes____ No____ If yes, please explain: ____________________________________________________________ ______________________________________________________________________________ Have you ever willfully and intentionally refused to pay rent when due? Yes____ No____ if yes, please explain:_____________________________________________________________ ______________________________________________________________________________ Are there any circumstances which may interrupt your income or ability to pay rent? Yes____ No____ If yes, please explain: ____________________________________________________________ ______________________________________________________________________________ Have you ever been convicted of a felony? Yes____ No ____ If yes, please explain: ____________________________________________________________ ______________________________________________________________________________ BANK REFERENCES: Name:_____________________________________________________________ Branch:_______________________________ Account No.:__________________________ Name:_____________________________________________________________ Branch:_______________________________ Account No.:__________________________ PERSONAL REFERENCES: Name:___________________________________________________________ Address:_________________________________________________________ Phone No.(_____)__________________ Relationship:____________________ Name:___________________________________________________________ Address:_________________________________________________________ Phone No.(_____)__________________ Relationship:____________________ Name:___________________________________________________________ Address:_________________________________________________________ Phone No.(_____)__________________ Relationship:____________________ CREDIT REFERENCES: Credit Card Name:_________________________________________________ Issuing Bank:_____________________________________________________ Account No.:__________________Credit limit:______________ Balance owed:_________________Monthly payment:___________ Expiration date:_______________Year Issued:______________ Credit Card Name:_____________________________________________ Issuing Bank:_________________________________________________ Account No.:_____________________Credit limit:_____________ Balance owed:____________________Monthly payment:__________ Expiration date:__________________Year Issued:_____________ Credit Card Name:_________________________________________________ Issuing Bank:_____________________________________________________ Account No.:__________________Credit limit:______________ Balance owed:_________________Monthly payment:___________ Expiration date:_______________Year Issued:______________ Credit Purchases (e.g. store account) Name:_________________________________________________________ Account No.:_____________________Credit limit:_____________ Balance owed:____________________Monthly payment:__________ Credit Purchases (e.g. store account) Name:_________________________________________________________ Account No.:_____________________Credit limit:_____________ Balance owed:____________________Monthly payment:__________ IF A SECOND ADULT WILL BE RENTING THE PREMISES, THEY WILL NEED TO COMPLETE A SEPARATE RENTAL APPLICATION FORM. Please provide names of other tenants, including children and anyone who will live with you, even if on a temporary basis. Name:_____________________________________________________________ Present Address:__________________________________________________ How long:___________Home Phone No.:_______________________________ Adult:_____Child's Age:_____ Relationship:________________________ Occupation:____________________________School:____________________ Name:_____________________________________________________________ Present Address:__________________________________________________ How long:___________Home Phone No.:_______________________________ Adult:_____Child's Age:_____Relationship:_________________________ Occupation:___________________________School:_____________________ Name:_____________________________________________________________ Present Address:__________________________________________________ How long:___________Home Phone No.:_______________________________ Adult:_____Child's Age:_____Relationship:_________________________ Occupation:___________________________School:_____________________ Name:_______________________________ Type/Breed:_________________________ Size:_______________________________ Indoor:_______Outdoor:_______ I represent that the information provided in this Application is true and correct to the best of my knowledge. R J Beardsley is authorized to verify the references, any information supplied by applicant, employment information given in this Application, and to request a credit check. _________________________________________ __________________ Applicant's Signature Date _________________________________________ __________________ Co-Applicant's Signature Date IT IS AGAINST THE LAW TO DISCRIMINATE AGAINST PROSPECTIVE TENANTS ON THE BASIS OF RACE, RELIGION, NATIONAL ORIGIN, AGE, OR DISABILITY. 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 R J Beardsley to determine whether to accept this Application. Upon written request within 60 days, R J Beardsley will disclose to the Applicant in writing the nature and scope of any investigation R J Beardsley has requested, and will, if the Application is refused, state in writing the reason for said refusal. Accepted ________ Refused _________ For Office Use Only: By:________________________________________ R J Beardsley P O Box 160294 Sacramento, California 95816-0294 _ _______________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ Dear Employer: We are in the process of confirming information provided by a prospective tenant who has provided your name as employer in connection with a rental application. Please verify the information provided by the tenant by telephone or return the form to me at the above address. My phone number is (916) 451-6750. The best time to reach me is Private telephone recorder.. Thank you for your cooperation. R J Beardsley _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ TENANT SUPPLIED INFORMATION Prospective Tenant's Name:_______________________________________ Position:___________________________________________________ Wage/Salary:___________________ Per:____________ Length of time with above Employer:_________________________ I have completed the above information in connection with a rental application. The addressee of this letter is authorized to verify this information and supply the above named landlord with the information requested in the following items. Your response is solely a matter of courtesy for which no responsibility is attached to your institution or any of your officers. Prospective Tenant's Signature:________________________________________________________ R J Beardsley P O Box 160294 Sacramento, California 95816-0294 VERIFICATION TO BE COMPLETED BY EMPLOYER Is the employment information correct? Yes____ No____ Is this employment: Part-time______ Full-time______ Temporary______ Permanent______ Information provided by: __________________________________________ Title: _____________________________________Date:________________ R J Beardsley P O Box 160294 Sacramento, California 95816-0294 _________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ Dear Sir or Madam Please verify the following information provided in connection with a rental application by the prospective tenant named below. R J Beardsley _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ TENANT SUPPLIED INFORMATION Name of Prospective Tenant(s): ___________________________________________________ ___________________________________________________ Address:__________________________________________________________ _________________________________________________________________ Type of Account: Checking______Savings______Other:______________ Account Number:__________________________Balance: $____________ Type of Account: Checking______Savings______Other:______________ Account Number:__________________________Balance: $____________ I have completed the above information in connection with a rental application. The addressee of this letter is authorized to verify this information and supply the above named landlord with the information requested in the following items. Your response is solely a matter of courtesy for which no responsibility is attached to your institution or any of your officers. ______________________________ _____________________________ Signature of Account Holder Signature of Account Holder R J Beardsley P O Box 160294 Sacramento, California 95816-0294 VERIFICATION TO BE COMPLETED BY BANK Type of Account: Checking_____Savings_____Other:____________ Account Number:__________________________ Balance: $____________ Average Balance for previous two months: $____________ Date Account opened:________________ Type of Account: Checking_____Savings_____Other:____________ Account Number:__________________________Balance: $____________ Average Balance for previous two months: $____________ Date Account opened:________________ Signature:______________________________________Date:___________ Title:____________________________________ PLEASE RETURN THIS FORM TO THE LANDLORD AT THE ABOVE ADDRESS.