Rental Application

Proposed
Occupants
List All
in addition
to yourself

Do you have pets?

Will you have liquid filled furniture?

Residential Rental Application
(All Sections Must Be Completed)

Individual applications required from each applicant

Last Name	First Name	Middle Name	Social Security Number
Date of Birth	Drivers license No.	State	Home Phone Number

1	Present Address City State Zip Code
	Date in	Date out	Owner/Mgr	Owner/Mgr Phone No.
	Reason for Moving
2	Previous Address City State Zip Code
	Date in	Date out	Owner/Mgr	Owner/Mgr Phone No.
	Reason for Moving
3	Previous Address City State Zip Code
	Date in	Date out	Owner/Mgr	Owner/Mgr Phone No.
	Reason for Moving

1	Present Occupation	Employer Name
	How long with this employer	Employer Address
	Name of your supervisor	Employer phone no.
2	Previous Occupation	Employer Name
	How long with this employer	Employer Address
	Name of your supervisor	Employer phone no.

Current gross income $ Per	Check one below			Please list ALL of your financial obligations below
	Wk.	Mo.	Yr.

Name of your bank	Branch or adress	Account number

Name of creditor	Address	Phone Number	Payment Amount

In case of emergency, notify:	Address	Phone	City	Relationship
1.
2.
Personal References	Address	Phone	City	Length of aquaintance
1.
2.

Mother's maiden name

________________________________________________________

Automobile: Make ________ Model ________ Year ____ Reg. State __ Vehicle license number _________
Automobile: Make ________ Model ________ Year ____ Reg. State __ Vehicle license number _________
Motorcycles (other vehicles)
________________________________________________________

Have you ever filed for bankruptcy? ________________________________________________________

Have you ever been evicted or asked to move? ________________________________________________________
Applicant represents that all the above statements are true and correct and hereby authorizes verification of the above items including but not limited to the obtaining of a credit report and agrees to furnish additional credit references on request.

The undersigned makes application to rent housing accomodations designated as: Unit # __________ Located at
________________________________________________________,
the rent for which is $ ______ per ______ and upon approval of this application agrees to sign a rental or lease agreement and to pay all sums due, including required deposits, before occupancy.

Dated: ________________, 20__
Signature of Applicant: __________________________________

Notice: California Lifestyles Realty enthusiastically supports and complies with all state and federal laws and regulations in the management and processing of applications for residential rental property it manages.
This form is copyrighted and may not be reproduced without the expressed written consent of California Lifestyles Realty

California Lifestyles Realty Property Management Division
Property Manager: Joyce Mullins
Office Phone: 707-822-1300 ext. 301
Office Fax: 707-822-2915

USPO Address: 407 F St., Arcata, CA 95521

Note: This application does not constitute an offer to rent or lease and is provided for your convenience only. There is no cost to applicants for processing this application although you may be asked to provide a current credit report from a credit reporting agency of our choice. The cost of credit report is typically minimal and may be used by California Lifestyles Realty only for the purpose of financial screening of applicants for properties which we manage or for other properties only with the expressed consent of the applicant. Our evaluation is based on financial status, credit history, and evaluation of references. Please provide complete and current information. California Lifestyles Realty is an Equal Housing Opportunity company.