RENTAL APPLICATION

Please fill out and return with payment

The undersigned hereby makes application to rent unit number _______ located at
__________________________________________________
beginning on  _________________ 200______ at a monthly rental $ ___________.

PLEASE TELL US ABOUT YOURSELF

FULL NAME: ___________________________ Phone: _______________________
Date of Birth: _____________________________ Social Security # _________________
Name of Co-Applicant ________________________________________
Date of Birth: _____________________________ Social Security # _________________
Number of Dependents(excluding Co-Applicant) __________ Ages of Dependants__________
Other Occupants and their relationship ____________________________________________
Pets (Number and Kind) ________________________________________________

PLEASE LIST YOUR RENTAL HISTORY FOR THE PAST 3 YEARS
(Current residence first)

CURRENT ADDRESS: ________________________________________________
Month and Year Moved In __________________ Reason for leaving _____________
Monthly Rent$ ___________ Owner or Agent _________________________
Phone (        ) __________________

CURRENT ADDRESS: ________________________________________________
Month and Year Moved In __________________ Reason for leaving _____________
Monthly Rent$ ___________ Owner or Agent _________________________
Phone (        ) __________________

CURRENT ADDRESS: ________________________________________________
Month and Year Moved In __________________ Reason for leaving _____________
Monthly Rent$ ___________ Owner or Agent _________________________
Phone (        ) __________________

PLEASE GIVE YOUR EMPLOYMENT INFORMATION

Employer __________________________________________________________
Date(s) Employed ____________________ Position________________________________
Supervisor ____________________________ Supervisor's Phone # ___________________
Address ____________________________________________________________
Salary $ ___________ Per _____________ If employed by above less than 6 months, give name
and address of previous employer   _________________________________________

If there are other sources of income you would like us to consider, please list income, source and person
 who we can contact for confirmation.

Amount $_________________Source__________________________________________
Contact_______________________________

CREDIT REFERENCES

1. ___________________________________________________________________
2. ___________________________________________________________________
3. ___________________________________________________________________

YOUR DRIVER'S LICENSE NUMBER _____________________ STATE ________________

YOUR VEHICLE MAKE/MODEL _____________YEAR_____ TAG NO.______ STATE_____
SECOND VEHICLE MAKE/MODEL _____________YEAR_____ TAG NO.______ STATE____

Have you ever?

1. File for bankruptcy?   ______ No _____ Yes
2. Been evicted from tenancy  ______ No _____ Yes
3. Willfully or intentional refused to pay rent when due?  ______ No _____ Yes

PLEASE GIVE ANY ADDITIONAL INFORMATION WHICH MIGHT HELP MANAGEMENT
EVALUATE THIS APPLICATION.

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

If management has any questions about this applications, please give PHONE NUMBERS where
you can be reached.

DAY PHONE(s) _______________________________________________________
NIGHT PHONE(s)______________________________________________________
CELL PHONE(s)______________________________________________________

I/we hereby apply to lease the above described premises for the term of and upon the conditions above set forth and agree that the rent is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application, I warrant that all the statements above set forth are true.

I hereby deposit $ ___________ as the application fee. If approved and accepted I agree to execute a lease for _______ months before possession is given and to pay the security deposit within _________ business banking days after being notified of my acceptance.

I RECOGNIZE THAT AS PART OF YOUR PROCEDURE FOR PROCESSING MY APPLICATION, AN INVESTIGATIVE CONSUMER REPORT, INCLUDING CREDIT, EMPLOYMENT CHARACTER AND REPUTATION, MAY BE PREPARED WHEREBY INFORMATION IS OBTAINED THROUGH PERSONAL INTERVIEWS.

The above information, to the best of my knowledge, is true and correct.

Signature of Applicant _________________________ Date Signed _______________

Signature of Applicant _________________________ Date Signed _______________

DEPOSIT OF $ ________ RECEIVED BY ________________ DATE ______________

The information is for internal use by V.S. Property Services, Inc. only.