Application to Lease

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

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):

PERSONAL REFERENCES: (Relatives & Friends):

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

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:

I agree that this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature.
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 Draw It Type It		Spouse’s Signature Draw It Type It
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