Rental Application
| Owner: | Scranton Veatch LLC |
| Property Manager: |
Theresa Tyler-Smith
ttylersmit@aol.com
1(570)709-0170 |
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| Today's Date: | ________________ |
| Lease Begins: | ________________ |
| Lease Ends: | ________________ |
| Address: | 1005 S Webster Ave., Unit ___ |
| | Scranton PA 18505 |
| Monthly Rent: | $_______ |
| Security Deposit: | $_______ |
| Background Check Fee: | $_______ |
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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 (circle one) 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, use the back.)
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, use the back.)
Employed: (circle one) Full-time Part-time Unemployed Retired Student. Start Date __/__/____
Employed by: _______________________________________ (check one) Current __ Past __
Employer's Address ____________________________________________ Phone ( )____-________
Job/Position___________________ Income $_______ per_____ Employer's Name_________________
If student, where: _________________________ Advisor _____________ Phone ( )____-________
Major ____________________________ Present year (circle one) 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, what type of infestation?___________________
Personal References (Please do not use a relative or someone previously listed on this application.)
Name_________________________________ Phone ( )____-________ Relationship____________
Name_________________________________ Phone ( )____-________ Relationship____________
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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.
Applicant's Signature ________________________________________________ Date ______________
Parent/Guardian Signature ________________________________________________ Date ______________
WITH THE ABOVE SIGNATURE(S), I/WE AUTHORIZE OWNER TO PROVIDE ANY AND ALL INFORMATION OR DOCUMENTATION REQUESTED
| Application Taken By: | Reference Checks By: | Approved By: |
| ______________________ | _______________________ | __________________ |
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