Tenant Application
Eagle Creek Tenant Application
APPLICANT INFORMATION:
Name (full name): ________________________________________________________
Social Security Number: __ __ __ - __ __ - __ __ __ __ DOB: ____ / ____ / ____
Your Lincoln Phone: ___________________________
Parents PHONE ___________________________
YOUR Work Phone: _______________________
Your E-Mail Address _____________________________________________________
Your Driver's License / ID Number: _________________________ State: ______________
Your Declared Major ___________________________________________________
How Many Years of College until Graduation ____________________________________
What College do you Attend ________________________________________________
APPLICANT VEHICLE(S):
Make: ______________________ Model: _______________________ Year: ________
Make: ______________________ Model: _______________________ Year: ________
APPLICANT EMPLOYMENT HISTORY:
Current Employer:
Name and Address: _______________________________________________________
Phone: ___________________________
Supervisor: ____________________________ Supervisor Phone: ___________________
Length of Employment: Begin ______________ Still employed? (Check one) ___ yes ___ no
Previous Employer(s):
Name and Address: _______________________________________________________
Phone: _ ___________________________
Supervisor: ____________________________ Supervisor Phone: ___________________
Length of Employment: Begin ______________ End ____________________________
Name and Address: _______________________________________________________
Phone: ___________________________
Supervisor: ____________________________ Supervisor Phone: ___________________
Length of Employment: Begin ______________ End ____________________________
RENTAL HISTORY:
Current Address: _________________________________________________________
Dates Lived at This Address: From ________________ To _______________________
Reason for leaving: _______________________________________________________
Landlord/Manager: _____________________ Landlord/Manager's Phone: ____________
Previous Address: ________________________________________________________
Dates Lived at This Address: From ________________ To ______________________
Reason for leaving: _______________________________________________________
Landlord/Manager: _____________________ Landlord/Manager's Phone: ____________
Previous Address: ________________________________________________________
Dates Lived at This Address: From ________________ To _______________________
Reason for leaving: ________________________________________________________
Landlord/Manager: _____________________ Landlord/Manager's Phone: _____________
APPLICANT INCOME:
Gross Monthly Employment Income Before Deductions: $__________________________
Gross Monthly Income From Other Sources (average): $__________________________
TOTAL GROSS MONTHLY INCOME: $__________________________
APPLICANT CREDIT and FINANCIAL INFORMATION:
Bank and Financial Accounts
Checking:
Institution Name ______________________ Branch ______________ Acct # ______________
Savings:
Institution Name ______________________ Branch ______________ Acct # _______________
Other (Money Market, etc):
Institution Name ______________________ Branch ______________ Acct # _______________
Credit Accounts
Credit Card: Type _______ Creditor ___________________________ Acct # _________________
Amt Owed $_______________ Monthly Payment $______________
Credit Card: Type _______ Creditor ___________________________ Acct # _________________
Amt Owed $_______________ Monthly Payment $______________
Loans: (mortgage, student loan, car, etc.)
Type ____________ Creditor ___________________________ Acct # ______________________
Amt Owed $_______________ Monthly Payment $______________
Type ____________ Creditor ___________________________ Acct # ______________________
Amt Owed $_______________ Monthly Payment $______________
Other: Type ____________ Creditor ___________________________ Acct # ________________
Amt Owed $_______________ Monthly Payment $______________
MISCELLANEOUS: (Check appropriate answer)
Do you have pets? _____ yes _____ no If so, describe __________________________________
Do you smoke? _____ yes _____ no
Do you plan to have water filled furniture on the rental property? _____ yes _____ no If yes, explain below.
Have you ever been evicted? _____ yes _____ no If yes, explain below.
Have you ever been convicted of a felony? _____ yes _____ no If yes, explain below.
Have you ever filed for bankruptcy? _____ yes _____ no If yes, explain below.
Explanation: ______________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
APPLICANT PERSONAL REFERENCES:
Name: ________________________________________ Relationship: _______________________
Address: __________________________________________ Phone: ________________________
Known this reference how long? _______________________
Name: ________________________________________ Relationship: _______________________
Address: __________________________________________ Phone: ________________________
Known this reference how long? _______________________
APPLICANT EMERGENCY CONTACT INFORMATION:
Contact in Emergency (Name): ______________________________ Relationship: _______________
Emergency Contact Address: _________________________________________________________
Phone: _____________________________________
I hereby certify and affirm that all information provided above is true and correct. I fully understand that my lease or rental agreement may be terminated if I have made any false, misleading or incomplete statement in this application. I hereby authorize verification of all information provided in this application, including financial and credit information, via credit bureaus and/or contact with current and previous employers, current and previous landlords and personal references.
___________________________________________ ____________________________
APPLICANT DATE
Print, Fill out ( as completely as possible for each roommate) and Sent to:
Chuck Earley
5219 Garland St.
Lincoln, Ne. 68504