Rental Application
| Owner: | Scranton Veatch LLC |
| Property Manager: |
Theresa Tyler-Smith
ttylersmit@aol.com
1(570)709-0170 |
|
|
|
Each adult must provide signed application and photo ID.
Read the Lease, Addendum, and Rules & Regulations.
We do NOT rent to anyone whose references we cannot contact.
We do NOT allow anyone to move in immediately.
|
Personal Information
First, Middle, Last Name:
SSN:
Birth Date:
Present Address:
City:
State:
Zip:
DL#/State Issued:
Tel #: ()-
Email:
Landlord Name:
Landlord Phone: ()-
Date moved in:
Marital Status:
Single
Married
Separated
Divorced
Current rent amount: $
Are you paying alimony?
No
Yes, $
paying child support?
No
Yes, $
Dependent Name:
Birth Date:
Dependent Name:
Birth Date:
Resident History | (We need the past 3 years. If more space is needed, add a Note below.) |
Previous Address, City, State, Zip:
Landlord Name:
Mo/Yr Moved In: /
Mo/Yr Moved Out: /
Landlord Phone: ()-
Reason for leaving:
Rent: $
Previous Address, City, State, Zip:
Landlord Name:
Mo/Yr Moved In: /
Mo/Yr Moved Out: /
Landlord Phone: ()-
Reason for leaving:
Rent: $
Employment Information
(If you are not currently employed, list most recent employer. If you have more than one employer or spouse is employed, add a Note below.)
Employed:
Full-time
Part-time
Unemployed
Retired
Student
Start Date:
Employed by:
Current
Past
Employer's Address:
Phone: ()-
Job/Position:
Income: $ per
Employer's Name:
If student, where:
Advisor:
Phone: ()-
Major:
Present year:
FR
SOPH
JR
SR
GRAD
Other Information
Local Contact:
Address:
Phone: ()-
Nearest Relative:
Address:
Phone: ()-
Emergency Contact:
Address:
Phone: ()-
Disability status and require special accommodations?
Bank:
Acct#:
Branch:
Tel#: ()-
Additional Income (Interest, Child Support, Etc.):
Primary Vehicle Make/Model/Color:
Yr:
License #:
State:
Second Vehicle Make/Model/Color:
Yr:
License #:
State:
Other vehicles:
Yr:
License #:
State:
Ever been evicted or refused to pay rent?
No
Yes
Ever filed bankruptcy?
No
Yes
Ever been or are you currently an illegal abuser of any controlled substance?
No
Yes
Are you a Registered or Unregistered Sex Offender?
No
Yes
If yes, to any of the above, give details. What charge? What county/state? When?
Ever used any other name(s)?
No
Yes. If Yes list name(s):
Do you smoke?
No
Yes
Have a waterbed?
No
Yes
Pet(s)?
No
Yes
If Pet(s): Breed:
Age:
Weight:
Name: (pet deposit $500, pet rent $50/mo)
Ever had bedbugs or other infestation? If yes, describe:
Personal References (Please do not use a relative or someone previously listed on this application.)
Name:
Phone: ()-
Relationship:
Name:
Phone: ()-
Relationship:
Notes
|
Letter of Authorization:
To Whom it May Concern:
In compliance with the Fair Credit Reporting Act, State and Federal
laws, this is to inform you and your household members that an
investigation involving the statements made on this application for
tenancy is being initiated by MyRental.com. I certify that to the best
of my knowledge all statements are true and complete. I further
authorize to obtain CREDIT REPORTS, EMPLOYMENT REFERENCES (including
verifying salary), COURT, CRIMINAL & JUVENILE RECORDS, ARREST
DETENTION INFORMATION and CHARACTER REFERENCES, GENERAL REPUTATION,
MODE OF LIVING and RENTAL REFERENCES as needed to verify all
information put forth on this application and otherwise available
regarding all applicants identified on this application (for juvenile
occupants, the undersigned parent/guardian authorizes the
above-information to be obtained on their behalf).
Furthermore I warrant the accuracy of all information contained on
this rental application including that relating to the other intended
occupants of the subject property. I understand and agree that if
subsequently a determination is made that I provided false or
inaccurate information on the rental application it is a breach of the
terms of any rental agreement signed based on that information and
Owner and/or Owner's agent(s) may take legal action to terminate said
Agreement.
I give permission for Owner, Property Manager, and prospective
co-tenants if any, to receive and view the aforementioned reports and
information.
I further affirm and acknowledge that: I cannot move in until the
application is approved, and the lease (original or as modified) is
approved and signed by all parties thereto, and the Security Deposit
is paid in full. All rent is due and payable on the 1st day of the
month in advance. I/we hereby apply to lease the above described
premises on the terms above specified and have deposited $
earnest money to be refunded to me if this application is not
accepted. In the event no verifiable rental history is available, I
will increase my deposit to an amount equal to two months rent. I
also understand that if I am an undergraduate student I may be
required to have a parent co-signature on the lease. If the Owner
accepts this application, I understand that I/we are obligated to sign
a lease for said premises within seven (7) working days. If I/we fail
to sign the lease, all monies paid are to be retained by the Owner as
liquidated damages and there shall be no further liability on the part
of the Owner or his agent in respect to said proposed lease for this
application.
Signatures:
Applicant's Signature: /x/
Date:
Parent/Guardian Signature: /x/
Date:
|