Rental Application - Campora Development

What type of property are you looking to rent?DuplexHouse

Desired Move-In Date

Applicant Information

First Name *

Middle Name

Last Name

Date of Birth *

Month *

Day *

Year *

Social Security Number *

Driver's License Number

Driver's License State

Driver's License Expiration Date

Phone Number *

Email Address *

Current Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

How Long at Current Address?

Current Landlord Information

Landlord Name

Landlord Phone

Monthly Rent

USD

Reason for Moving

Previous Residence

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

Dates of Residence

Employment Information

Current Employer

Employer Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

Position

Supervisor Name

Work Phone

Length of Employment

Gross Monthly Income

Additional Income Sources

Other Potential Occupants

Each potential occupant must complete an application.

Name

Date of Birth

Pets

Do you have pets?YesNo

If yes, describe:If you have a pet, prior to move in, you will have to submit pet information to have the pet approved and, if approved, you will have to pay a nonrefundable pet deposit of $400.00 and obtain renter’s insurance to cover you and Campora Development in the event you pet bites or otherwise injures someone on the property.

Vehicles

Make

Model

Year

Emergency Contact

Name

Relationship

Phone

Background Information

If you are a student, with insufficient income, your parents will have to guarantee payment of any lease.

Been evicted? *YesNo

Filed bankruptcy? *YesNo

Been convicted of a felony? *YesNo

Refused to pay rent when due? *YesNo

If yes to any of the above, explain:

Authorization

I certify that the information provided in this application is true and complete. I authorize the landlord or property manager to verify all information provided, including employment, rental history, credit history, and criminal background information.

Signature

Date *