FLORIDA APPLICATION TO RENT Applicant’s Name: * Birth Date: * Driver’s Lic.#: Home phone: SSN: Cell phone: * Work phone: E-Mail Address: * I also affirm the following will be the residents of the property: (Please list the first and last names of all prospective residents, including yourself). Click the "+" button to add more Full Name: * Age: * Sex: * If you are under 18 of age then please provide below information: SSN: Date of Birth: Email: -+ RENTAL HISTORY Present Address: * City: County: State: Zip: Landlord: Phone: Rent Amount: Rent From: to: 30 Day notice given ?: Reason For Leaving Former Address: City: County: State: Zip: Landlord: Phone: Rent Amount: * Rent From: * to: * 30 Day notice given ?: Reason For Leaving EMPLOYMENT HISTORY Current Employment: Phone: Supervisor: Your Position: Length Employed: to: FT: PT: Salary: Per: Previous Employment: Phone: Supervisor: Your Position: Length Employed: to: FT: PT: Salary: Per: ADDITIONAL INFORMATION Will you have any water filled furniture?NoYes If so, please specify Have you ever declared bankruptcy?NoYes If so, when? Have you ever had an eviction filed against you?NoYes If so, please specify Have you ever been charged with a felony?NoYes If so, please specify Have you ever been charged with a misdemeanor?NoYes If so, please specify Have you ever refused to pay rent/broken a lease?NoYes If so, please specify EMERGENCY CONTACT INFORMATION Name: Relationship: Home phone: Cell phone: Work phone: Applicant represents that all of the statements and representations are true and complete, and hereby, authorizes our company verification of the above information, references and credit report. Applicant understands that an investigative consumer report including information about character, credit history, general reputation, personal characteristics, mode of living, and all public record information including criminal records may be made. Applicant hereby gives permission to our company to disclose the result of the credit report to the Owner of the rental property to which applicant is applying for and hisher licensed representative for the purpose of evaluating the applicants ability to perform under the rental agreement. Applicant 1 Signature: * Applicant 2 Signature: Applicant 3 Signature: Applicant 4 Signature: Date: *
