509 Sterling Hwy., Ste 202
Homer, AK 99603
Rental
Application
Office (907) 235-1958
Fax (907) 235-2652
E-mail: rentals@xyz.net
Application Date:
____________________
Please complete the following
information as accurately as possible.
All applicants must be at least 18 years of age and provide at least one
year of non-related rental or mortgage information for approval. Please include the application fee to begin
processing. Thank you.
Requested Property
Information: (for office use only)
Property Address: _______________________________________________________________________________________________
Requested Move-In Date: ______________________ Rent Amount: $________________ + sales tax
Security Deposit Amount: $________________ ~ A deposit paid in full will hold a property pending the
application approval.
Applicant Information:
First Name: _______________________________ M.I.
_____ Last Name: ____________________________________
Social Security #: _____________________ Drivers License #: _____________________ State: _______
Mailing Address: ____________________________________ City: ________________ State: _____ Zip: ____________
Home Phone: _________________ Work Phone: ________________ Cell Phone: ________________ E-mail: ______________________
Vehicle Year: __________ Make: ____________________ Model:
____________________ License Plate #:
_____________________
Landlord/Mortgage History:
Present
Address: _______________________________Unit: ___ City:
______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent □
Mortgage Date In: ____________ Date Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Previous
Address: _______________________________Unit: ___
City: ______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent □
Mortgage Date In: ____________ Date Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Previous
Address: _______________________________Unit: ___
City: ______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent □
Mortgage Date In: ____________ Date Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Employment/Income
Information:
Employer: _______________________________________________________________ Position:
________________________________
Employer
Address:
______________________________________ City: __________________ State:
_____ Zip: ____________
Supervisor’s
Name: _________________________________________ Supervisor’s Phone: ___________________________
Monthly
Pay: $___________________ Length of Employment: __________________ □ Full-Time
□ Part-Time □
Seasonal
Previous
Employer:
_______________________________________________________ Position:
________________________________
Employer
Address: ________________________________________ City:
__________________ State: _____
Zip: ____________
Supervisor’s
Name: _________________________________________ Supervisor’s Phone: ___________________________
Monthly
Pay: $___________________ Length of Employment: __________________ □ Full-Time
□ Part-Time □
Seasonal
Reason
for Leaving:
_____________________________________________________________________________________
Please attach proof of income for the following (i.e.
statement, check stub, etc.):
Other Income Source: _______________________________ Amount:
$___________________ □ Monthly □
Yearly
Other Income Source: _______________________________ Amount:
$___________________ □ Monthly □
Yearly
Personal References:
Please include non-relative references only.
Name: _______________________ Address:
________________________________
Phone: ________________ Years Known: _____
Name: _______________________ Address:
________________________________
Phone: ________________ Years Known: _____
Emergency Contact:
Name: ______________________ Address:
_________________________
Phone: ________________ Relationship: ______________
Co-Applicant
Information:
First Name: _______________________________ M.I.
_____ Last Name: ____________________________________
Social Security #: _____________________ Drivers License #: _____________________ State:
_______
Mailing Address: ____________________________________ City:
________________ State: _____
Zip: ______________
Home Phone: _________________ Work Phone: ________________ Cell Phone: ________________ E-mail:
______________________
Vehicle Year: __________ Make: ____________________ Model:
____________________ License Plate #:
_____________________
Landlord/Mortgage
History:
Present
Address: ________________________________Unit: ___
City: ______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent
□ Mortgage Date In: ____________ Date
Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Previous
Address: _______________________________Unit: ___
City: ______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent □
Mortgage Date In: ____________ Date Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Previous
Address: _______________________________Unit: ___
City: ______________ State:
_____ Zip: _______________
Rent
Amount: $_____________ Per Month □ Rent □
Mortgage Date In: ____________ Date Out: _________
Owner/Manager
Name: ______________________________________ Owner/Manager Phone #: ____________________
Reason
for Moving: ________________________________________________________________
Employment/Income
Information:
Employer: ______________________________________________________________ Position:
________________________________
Employer
Address: ________________________________________ City:
__________________ State: _____
Zip: ____________
Supervisor’s
Name: _________________________________________ Supervisor’s Phone: ___________________________
Monthly
Pay: $___________________ Length of Employment: __________________ □ Full-Time
□ Part-Time □
Seasonal
Previous
Employer:
_______________________________________________________ Position:
________________________________
Employer
Address:
________________________________________ City: __________________ State:
_____ Zip: ____________
Supervisor’s
Name: _________________________________________ Supervisor’s Phone: ___________________________
Monthly
Pay: $___________________ Length of Employment: __________________ □ Full-Time
□ Part-Time □
Seasonal
Reason
for Leaving:
_____________________________________________________________________________________
Please attach proof of income for the following (i.e.
statement, check stub, etc.):
Other Income Source: _______________________________ Amount:
$___________________ □ Monthly □
Yearly
Other Income Source: _______________________________ Amount:
$___________________ □ Monthly □
Yearly
Personal References:
Please include non-relative references only.
Name: _______________________ Address:
________________________________
Phone: ________________ Years Known: _____
Name: _______________________ Address:
________________________________
Phone: ________________ Years Known: _____
Emergency Contact:
Name: ______________________ Address:
__________________________
Phone: _______________ Relationship: ______________
Household Information:
Please list the name, age and
relationship of each person to live with you:
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Please provide information
regarding pets to live with you:
Type: ___________________ Age: _________ Color: _____________ Weight:
__________ lbs. Name: ____________________________
Type: ___________________ Age: _________ Color: _____________ Weight:
__________ lbs. Name: ____________________________
Are there any smokers? □
Yes □ No Do
you own a piano? □ Yes □ No
Please provide any other
information we should know:
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Application must be signed by
both parties before consideration by Landlord.
Acceptance of applicant, application, and money deposited herewith is
not binding until approval from Landlord has been granted. If Landlord or Agent denies the application,
all deposit moneys will be refunded less the NON-REFUNDABLE application
fee. If the applicant should withdraw
the application after 72 hours of placing the deposit, the deposit shall be
forfeited to the Landlord. Properties
can be held for a MAXIMUM or 14 calendar days from the day the deposit is
accepted.
I hereby authorize Homer
Property Management, Inc. to obtain consumer reports, and any other information
it deems necessary, for the purpose of evaluating my application. I understand that such information may include,
but is not limited to, credit history, civil and criminal information, rental
history, employment/salary details and/or any other necessary information. Any information that is found to be
purposely misrepresented will result in the denial of this application and is
grounds for eviction.
I understand Homer Property
Management, Inc. has a fiduciary duty to the property owner and will negotiate
the lease terms and represent the rental on the owner’s behalf and in their
best interests. All properties are
offered to applicants without regard to race, color, creed, sex or national
origin.
I hereby expressly release Homer Property Management,
Inc. and any procurer or furnisher or information, from any liability
what-so-ever in the use, procurement, or furnishing of such information, and
understand that my application information may be provided to various local,
state and/or federal government agencies, including without limitation, various
law enforcement agencies.
________________________________________________ ________________________________________
Applicant Signature Date
_____________________________________________________ ________________________________________
Co-Applicant Signature Date
Please attach the
non-refundable application fee as follows:
Single
$ 25.00
Couple
$ 35.00
Roommates
$ 40.00
Thank you for submitting your
application. The application process
takes approximately two days to complete.
A representative will contact you shortly regarding the application
status and to schedule an appointment to sign the lease agreement.
We look forward to working
with you!
Security
deposit amount: $___________________ Paid on ______________
FOP __________________
Pet
deposit amount: ____________________
Paid on ______________ FOP __________________
First
month’s rent: ____________________ Paid on ______________ FOP __________________
Total
needed for occupancy $___________________
Copyright 1999-2004 Homer Property Management