RESIDENTIAL RENTAL APPLICATION

Landlord
Landlord Name: Karin Livingston
Address: 930 N. Shields St., Ft. Collins, CO 80521
Phone: 9702241215

Rental Property Information
Rental Property Address: 920 N Shields St., Ft. Collins, CO 80521
Application to rent suite #_______
Anticipated Possession Date: March 1, 2016
The term of the tenancy will be March 1, 2016 to May 31, 2017.
The monthly rent will be $1,400.
The initial security deposit will be $1,400.
If pet is approved, add $500 to security deposit.

Applicants' Personal Information

Applicant's Name:

Home Phone:

(          )

Alternative Phone:

(          )

Email Address (Optional):

Date of Birth:

Applicant's Social Security Number:

Second Applicant's Name:

Second Applicant's Date of Birth:

Second Applicant's Social Security Number:

Name(s) of Dependant(s):	Date(s) of Birth

Do you have a pet?      Yes / No       If more than one, how many? _______
Please describe type(s) of pet(s):

Present Address:

City:

State:

ZIP Code:

How long at this address?

Landlord / Lessor:

Phone:

(          )

Previous Address 1:

City:

State:

ZIP Code:

How long at this address?

Landlord / Lessor:

Phone:

(          )

Previous Address 2:

City:

State:

ZIP Code:

How long at this address?

Landlord / Lessor:

Phone:

(          )

Details of Employment

Employer:

Position:

Date Hired:

Supervisor's Name:

Phone:

(          )

Salary:

(If employed less than one year with present employer, please provide previous employer.)

Previous Employer:

Position:

Date Hired:

Supervisor's Name:

Phone:

(          )

Salary:

Other Sources of Income
Do you receive income from any of the following sources?     Yes / No
Student Loans ______ Pension Benefits ______ Social Assistance ______ Other ______
Please provide contact persons who could verify the amount of income you receive:

Make / Model:

Year:

License Plate Number:

Driver's License Number:

Make / Model:

Year:

License Plate Number:

Driver's License Number:

Parking stall required? Yes / No      Additional stall required? Yes / No (Subject to availability)

Banking Information

Banking Institution:

Address:

Phone:

(          )

(If you bank with more than one institution, please list second bank below)

Banking Institution:

Address:

Phone:

(          )

References

Name:

Phone:

(          )

Name:

Phone:

(          )

Emergency Contact

Name:

Relationship:

Phone:

(          )

Criminal & Credit Background Check Authorization

I declare that the information I have provided is accurate. I authorize the individual or organization to whom this application is submitted to: (a) contact my references and all other persons that I have named in this application; and (b) perform a credit and/or criminal check to assess my suitability as a tenant/lessee.