Address of rental property you are applying for

Tenant #1
(please fill out completely)

Tenant #2
(if applicable)

Name:

Name:

Date of Birth:

Date of Birth:

Present Address:

Present Address:

Present Phone #:

Present Phone #:

Cell Phone:

Cell Phone:

Present Landlord's Name:

Present Landlord's Name:

Present Landlord's Phone #:

Present Landlord's Phone #:

How Long At This Address:

How Long At This Address:

Current Rent:

Current Rent:

Employer:

Employer:

Employer Address:

Employer Address:

Employer Phone #:

Employer Phone #:

Length of Employment:

Length of Employment:

Gross Monthly Income:

Gross Monthly Income:

---

How many people will be living in the house? 1 2 3 4 Adults - 0 1 2 3 4 5 6 7 8 Kids - 0 1 2 3 4 5 6 7 8 Teenagers

---

Do you have a pet ? Dog No Yes - Cat No Yes - Other pets

---

Yes, I do No, I do not hereby authorize the above listed landlord (s) employer(s) and management company(s)

---

Yes, I do No, I do not authorize Regency Property Management Inc. to release information
regarding my tenancy as a reference to future landlords.

---

Yes, I do No, I do not hereby authorize the above listed to do a credit check

Comments: