Skip to content

Application to Lease

Please complete the form below. You can sign with a Digital Signature and submit it. Alternatively, you can download the form by clicking on the document icon on the right, then print, sign, scan and email or fax it.

    APPLICATION TO LEASE

    Applicant's Name
    EmailCellphone #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 BankCash BalanceAddress of BankAccount No.
    1.
    2.
    3.
    4.
    5.

    Real Estate

    Property #1Property #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):

    NameAddressPhone No. Cell & HomeOccupationRelationshipYrs. Known
    1.
    2.
    3.
    4.

    RESIDENCE:

    Present Address:
    OwnRentHow Long?
    Previous Address: (If less than 5 years)
    If Rent:
    MONTHLY INCOME (average)MONTHLY PAYMENTS (average) 
    Salary and/or Fees receivedLoan Payments
    Bonus & CommissionsRent/Lease
    Dividends & InterestTaxes (income & property taxes)
    Real Estate Net IncomeLiving Expenses
    Business Royalty IncomeGuarantor Obligations
    Other IncomeUnsatisfied Legal Claims/Judgment
    Liability as an endorser or co-maker of notes
    Other liabilities (alimony, child support, maintenance, etc.)
    TOTAL MONTHLY GROSS INCOMETOTAL MONTHLY EXPENSES

    AUTOMOBILES

    MakeModelColorYearLicense NumberCurrent ValueFinanced / Leased ByTelephone NumberLoan NumberAmount OwingMonthly Payment
    1.
    2.

    ACCOUNTS AND NOTES RECEIVABLE

    Name, Address and Phone # of DebtorMaturity DateFace ValueMonthly Installment PaymentsBalance DueDescription of Security
    1.
    2.
    3.

    MARITAL STATUS:

    MarriedDivorcedSingleSeparatedWidowedIf married, please provide the following:
    Spouse’s Name
    BirthdateSoc. Sec. No.Driver's Lic. No.
    Spouse’s EmployerEmployed for how long?

    STOCKS, BONDS & SECURITIES

    Name of Stock Certificate Holding CompanyAccount NumberAddressApprox. Current Total Market Value
    1.
    2.
    3.

    BUSINESS:

    Are You:Relocating?Expanding?Starting a new business?
    Name of Current BusinessType 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 locationAddress 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?YesNoB) 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/CompanySelf Employed:YesNo
    Company AddressPhone No.
    Length of Employment/OwnershipJob 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:9101112College:1234Graduate School:123456
    College/Graduate SchoolDegree & Year Graduated

    In case of emergency, notify:

    1) NameAddressPhone:
    2) NameAddressPhone:
    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

    Enter the code in the box below:
    captcha


    Notice: ob_end_flush(): failed to send buffer of zlib output compression (0) in /home/azusaglad/public_html/wp-includes/functions.php on line 5420