RENTAL APPLICATION ================================================================================ Thank you for your interest in our apartments. Please print when filling out information. Each individual applicant must complete and mail the entire application(three pages), proof of income (copies of each applicants last 3 check stubs), and a $25.00 application fee per applicant in the form of a Money Order to avoid delay in processing to the following address: HoumaRentals.com P.O. Box 2416 Houma, LA 70361 ================================================================================ Apartment wanted: __________________________ Location:_________________________ Type/Size: _____________________ Desired Date of Occupancy:____________________ May we contact you at a later date if application is approved and something becomes available? Yes / No ================================================================================ APPLICANT'S FULL NAME:___________________________________SSN:___________________ Date of Birth:______ Marital Status:____ Driver’s License #:____________St._____ OTHER RESIDENTS SSN Relationship Age ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Do You Own Furniture?_________ Pets?________ Other Remarks:_____________________ ================================================================================ PRESENT ADDRESS:____________________________________________ Zip Code: _________ Address City St. Present Telephone:____________________ Length of Time at Present Address:_______ Present Landlord or Mortgage Holder:_______________________ Phone:______________ Amount of Rent $_________________ Reason for Moving:____________________________ PREVIOUS ADDRESS:_______________________________________________________________ Address City State Zip Length of Time at Previous Address:__________ Reason for Moving:________________ Previous Landlord or Mortgage Holder:______________________ Phone:______________ Amount of Rent $_____________________ ================================================================================ EMPLOYED BY:__________________________________________ How Long? _______________ Employer's Address:___________________________________ Telephone:_______________ Position Held:__________________________________ Supervisor:____________________ CO-RESIDENT'S EMPLOYER:_______________________________ How Long? _______________ Employer's Address:___________________________________ Telephone:_______________ Position Held:__________________________________ Supervisor:____________________ ================================================================================ BANK:_________________________________________ Branch:__________________________ CREDIT REFERENCE:___________________________ Account Number:____________________ Address:_______________________________________ Telephone No:___________________ CREDIT REFERENCE:___________________________ Account Number:____________________ Address:_______________________________________ Telephone No:___________________ CREDIT REFERENCE:___________________________ Account Number:____________________ Address:_______________________________________ Telephone No:___________________ ================================================================================ Have you or any occupant who will be living in this apartment ever: (A) been evicted or asked to move out? (B)broken a rental agreement or lease contract? (C)declared bankruptcy? If yes, Explain: _______________________________________ ________________________________________________________________________________ Have you or any occupant who will be living in this apartment ever: (A)been sued for non payment of rent? (B)been sued for damages to rental property? If yes, Explain: _______________________________________________________________ Have you or any occupant who will be living in this apartment ever been convicted of a felony or currently under arrest or indictment in any court? Yes / No . If Yes, Explain: ____________________________________________________ ________________________________________________________________________________ ================================================================================ Number of Automobiles (incl. Company Cars):____ Co-Applicant DL#/St.____________ Make:_________ Year:___________ Color:_________ Tag No.:_________ State_________ Make:_________ Year:___________ Color:_________ Tag No.:_________ State_________ Household Income $_____________Per:_________ Other Remarks______________________ ================================================================================ In case of Personal Emergency, Notify________________ Relationship:_____________ Address:_____________________________________________ Telephone:________________ I hereby make application for an apartment and certify that this information is correct.I authorize you to contact any references, or contact any individuals' corporations or entities so that the information given can be verified or checked including the necessary parties to obtain or verify my police and criminal records.I hereby authorize and request any present or former landlord, employer, school, police department, financial institution, agency or other persons having personal knowledge about me, to furnish bearer with any and all information in their possession regarding me in connection with an application for residence. I hereby authorize you personally, or Credit Retriever, a service of Trans Union to obtain and verify such information including accessing consumer reporting agencies as well as performing a criminal and eviction record search.I have been notified that a consumer report will be requested and understand that the information that Credit Retriever obtains will be used in the processing of my rental application. I hereby release and hold harmless you, Credit Retriever, affiliates, employees and agents and any other organization that provides information from any and all liabilities arising out of the use of such information in connection with Credit Retriever. Referred By:____________________________________________________________________ __________________________ _________________________________ _____________ Applicant Print Name Applicant Signature Date __________________________ _________________________________ _____________ Co-Applicant Print Name Co-Applicant Signature Date ================================================================================ FOR OFFICE USE ONLY - DO NOT WRITE BELOW Application & Fee Received By:__________________________ Date:________________ ================================================================================ REFERENCE VERIFICATION REMARKS ____Present Landlord ___________________________________________________________ ____Previous Landlord __________________________________________________________ ____Employment _________________________________________________________________ ____Co-Resident Employment______________________________________________________ ____Bank _______________________________________________________________________ ____Credit (1) _________________________________________________________________ ____Credit (2) _________________________________________________________________ ____Credit (3) _________________________________________________________________ ____Other ______________________________________________________________________ Approved ____ Not Approved ____ Manager: _________________________ Date:_____________ ADVANCE DEPOSITS RECEIVED Date: _______________ Amount:________________________ Description: ________________________________________