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Application to Lease

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    APPLICATION TO LEASE

    Applicant's Name

    Email

    Cellphone #

    Birthdate

    Soc. Sec. No.

    Driver's Lic No.

    State

    CASH IN HAND & ALL CHECKING & SAVINGS BANK ACCOUNTS (Provide copy of most recent statement)

    Name of Bank

    Cash Balance

    Address of Bank

    Account No.

    1.

    2.

    3.

    4.

    5.

    Real Estate

    Property #1

    Property #2

    Property Address 

    Title, in whose name 

    Current Market Value (approx.) 

    Current Balance of First Loan 

    Monthly Payment – 1st Loan 

    Lender’s Name

    Lender’s Telephone No. 

    Loan Number 

    Current Balance of Second Loan

    Monthly Payment – 2nd Loan 

    Lender’s Name 

    Lender’s Telephone No. 

    Loan Number 

    Trade References (Where you buy from):

    1)

    2)

    PERSONAL REFERENCES: (Relatives & Friends):

    Name

    Address

    Phone No. Cell & Home

    Occupation

    Relationship

    Yrs. Known

    1.

    2.

    3.

    4.

    RESIDENCE:

    Present Address:

    Own

    Rent

    How Long?

    Previous Address: (If less than 5 years)

    If Rent:

    MONTHLY INCOME (average)

    MONTHLY PAYMENTS (average) 

    Salary and/or Fees received

    Loan Payments

    Bonus & Commissions

    Rent/Lease

    Dividends & Interest

    Taxes (income & property taxes)

    Real Estate Net Income

    Living Expenses

    Business Royalty Income

    Guarantor Obligations

    Other Income

    Unsatisfied Legal Claims/Judgment

    Liability as an endorser or co-maker of notes

    Other liabilities (alimony, child support, maintenance, etc.)

    TOTAL MONTHLY GROSS INCOME

    TOTAL MONTHLY EXPENSES

    AUTOMOBILES

    Make

    Model

    Color

    Year

    License Number

    Current Value

    Financed / Leased By

    Telephone Number

    Loan Number

    Amount Owing

    Monthly Payment

    1.

    2.

    ACCOUNTS AND NOTES RECEIVABLE

    Name, Address and Phone # of Debtor

    Maturity Date

    Face Value

    Monthly Installment Payments

    Balance Due

    Description of Security

    1.

    2.

    3.

    MARITAL STATUS:

    MarriedDivorcedSingleSeparatedWidowed

    If married, please provide the following:

    Spouse’s Name

    Birthdate

    Soc. Sec. No.

    Driver's Lic. No.

    Spouse’s Employer

    Employed for how long?

    STOCKS, BONDS & SECURITIES

    Name of Stock Certificate Holding Company

    Account Number

    Address

    Approx. Current Total Market Value

    1.

    2.

    3.

    BUSINESS:

    Are You:

    Relocating?Expanding?Starting a new business?

    Name of Current Business

    Type of Business

    Is it:

    CorporationPartnershipSole Ownership

    (PLEASE PROVIDE COPY OF CURRENT BUSINESS LICENSE)

    How long in business?

    Gross Monthly Income

    Landlord

    Proposed business at this location

    Address of space desired:

    Detailed description of business/services to be provided:

    List names of all major owners/directors of the organization:

    Have you ever filed for bankruptcy (under Chapter 7, 11 or 13) either personally or as a partial owner of an entity?

    NoYes

    If yes, please explain:

    A) Are you a defendant in any legal action?

    YesNo

    B) Are there any unsatisfied judgments?

    YesNo

    Have you ever been charged or convicted of a misdemeanor, felony or criminal charge, or pleaded nolo contendere to any charge, or been held liable in a civil action by final judgment, or been the subject of a material complaint or other legal proceedings? Have you ever been charged with civil action, complaint, fraud, embezzlement, fraudulent conversion, restraint of trade, unfair or deceptive practices, misappropriation of property, or comparable allegations?

    YesNo

    If yes, please explain:

    PRESENT EMPLOYMENT:

    Employer/Company

    Self Employed:

    YesNo

    Company Address

    Phone No.

    Length of Employment/Ownership

    Job Title (if applicable)

    Monthly Gross Income

    PLEASE PROVIDE THE FOLLOWING DOCUMENTS:

    1.) Copies of personal Tax returns of all principals for the last 2 years (and if applicable, company Tax returns)

    2.) Current personal and/or company financial statements with last 2 months bank statements, checking and savings

    3.) Copy of any professional licenses

    4.) Copy of current business license

    5.) Copy of current driver license

    EDUCATION:

    Select the last year of school completed:

    High School:

    9101112

    College:

    1234

    Graduate School:

    123456

    College/Graduate School

    Degree & Year Graduated

    In case of emergency, notify:

    1) Name

    Address

    Phone:

    2) Name

    Address

    Phone:

    I certify that the answers given on this application are true and correct and that I have withheld nothing that would, if disclosed, affect this application. I understand that investigative background inquiries are to be made on myself and my spouse, including consumer credit, driving, civil, criminal, bank statements and verification of deposits and other reports, including various federal, state and other agencies which maintain records concerning our past activities relating to our background. These reports will include information about me and my spouse and our financial information. I authorize release of any information deemed necessary by Landlord and its designated representative(s), at anytime to verify the enclosed information contained or any additional information required.

    Applicant’s Signature

    Spouse’s Signature

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