Lease Application

personal details

Name

Email address

Home/Cell Phone

Date of Birth (DD/MM/YYYY)

Social Security

Emergency Contact#

Number of people to occupy Apt:

Adults

Children

Lease Term

Pets

Breed

llbs

Apt#

Address

Monthly Rent$

Start Date (DD/MM/YYYY)

residence history

Present address

City

State

Zip

Reason for leaving

Rent

Present landlord

Tel:

Previous address

Zip

How Long

Previous landlord

Tel:

employment

Employed by

Tel

How long

Address

Position

Income

Supervisor

Tel

Previous employer

How long

Address

Position

Income

Additional Sources of Income

Education

bank references

Bank

Savings acc#

Bank

Checking acc#

terms & conditions

At the request of the landlord, the tenant agrees to be flexible in terms of "the move in" date regardless of the commencement date stated on the lease. In that event, landlord will prorate tenants accordingly.

The undersigned authorizes Roseann Lettieri Realty Corp. to obtain a credit, and/or criminal report from a recognized credit reporting agency