Application To Rent Gl Form

APPLICATION TO RENT/SCREENING FEE (C.A.R. Form LRA, Revised 4/03)

I. APPLICATION TO RENT THIS SECTION TO BE COMPLETED BY APPLICANT. A SEPARATE APPLICATION TO RENT IS REQUIRED FOR EACH OCCUPANT 18 YEARS OF AGE OR OVER, OR AN EMANCIPATED MINOR. Applicant is completing Application as a (check one) ✘ tenant, tenant with co-tenant(s) or guarantor/co-signor. Total number of applicants__________________________________________________________________________________

PREMISES INFORMATION

Application to rent property at____________________________________________ (“Premises”) Rent: $___________ per ________ Proposed move-in date___________________ PERSONAL INFORMATION FULL NAME OF APPLICANT _________________________________________________________ Social Security No ________________ Drivers License No. __________________ State ______ Expires_______ Phone number: Home___________________ Work ___________________ Other ____________________________ Email________________________________________________________________________________________________ Name(s) of all other proposed occupant(s) and relationship to applicant __________________________________________ _____________________________________________________________________________________________________ Pets or service animal (number and type) ___________________________________________________________________ Auto: Make _________ Model ________ Year ________ License No. ________ State ___ Color_________ Other vehicle(s): _______________________________________________________________________________________ In case of emergency, person to notify___________________________ Relationship___________________________ Address ___________________________________ Phone ________________________________________________ Does applicant or any proposed occupant plan to use liquid filled furniture? ✘ No Yes Type Has applicant been a party to an unlawful detainer action or filed bankruptcy within the last seven years? No If yes, explain _________________________________________________________________________________________ Has applicant or any proposed occupant ever been convicted of or pleaded no contest to a felony? No Yes If yes, explain _________________________________________________________________________________________ Has applicant or any proposed occupant ever been asked to move out of a residence? No Yes If yes, explain _________________________________________________________________________________________

RESIDENCE HISTORY Current address ____________________________________ City/State/Zip ______________________________________ From ___________________ to _______________________ Name of Landlord/Manager ___________________________ Landlord/Manager’s phone ____________________________ Do you own this property? No Yes Reason for leaving current address _______________________________________________________________________ Previous address ____________________________________ City/State/Zip ______________________________________ From ___________________ to _______________________ Name of Landlord/Manager ___________________________ Landlord/Manager’s phone ____________________________ Do you own this property? No Yes Reason for leaving current address _______________________________________________________________________

EMPLOYMENT AND INCOME HISTORY Current employer_______________________________ Supervisor _______________________ From _______ to ________ Employer’s address __________________________________________________ Supervisor’s Phone ___________________ Position or title _________________________________ Phone number to verify employment _________________________ Employment Gross Income $ _____________ per _____ Other $ ____________ per ________ Source __________________ Previous Employer _______________________________ Supervisor ____________________ From _______ To __________ Employer’s address ___________________________________________________ Supervisor’s phone __________________ Position or title __________________________________ Employment Gross Income $ ___________ per ________________ (PAGE 1 of 2) APPLICATION TO RENT/SCREENING FEE Applicant’s initials (____) (_______) Agent: George Lange Broker: Century 21 Adobe Realty

Phone: (818)297-7664

Fax: (818)338-1100 Lic# 01773119 5683 Kanan Road, Agoura Hills, CA 9130

Property Address: _____________________________________________________ Date _____________

CREDIT INFORMATION

Name of creditor _______________________________________ _______________________________________

Account number Monthly payment Balance Due _______________ _______________ _____________ _______________ _______________ _____________

Name of bank/branch _______________________________________ _______________________________________

Account number Type of Account Account Balan _______________ _______________ _____________ _______________ _______________ _____________

PERSONAL REFERENCES Name _____________________________ Phone _____________________________ Name _____________________________ Phone _____________________________

Address _________________________________________________________ Length of acquaintance ___________________ Occupation ________________ Address _________________________________________________________ Length of acquaintance _____________________________________________

Name _____________________________ Phone _____________________________ Name _____________________________ Phone _____________________________

Address _________________________________________________________ Length of acquaintance ___________________ Occupation ________________ Address _________________________________________________________ Length of acquaintance _____________________________________________

NEAREST RELATIVES

Applicant understands and agrees: (i) this is an application to rent only and does not guarantee that applicant will be offered the Premises; and (ii) Landlord or Manager or Agent may accept more than one application for the Premises and, using their sole discretion, will select the best qualified applicant. Applicant represents the above information to be true and complete, and hereby authorizes Landlord or Manager or Agent to : (i) verify the information provided; and (ii) obtain credit report on applicant. If application is not fully completed, or received without the screening fee: (i) the applicant will not be processed, and (ii) the application and any screening fee will be returned.

X

Applicant signature___________________________ Date _________________ Time_____________

I ___________________ authorize either Listing Agent or Seller Agent to process my credit report ($30) I will provide my own credit report (less than 3 months old)

X

Applicant signature __________________________ Date __________________ Time _____________

(PAGE 2 of 2) APPLICATION TO RENT/SCREENING FEE Agent: George Lange Broker: Century 21 Adobe Realty CA 91301

Phone: (818)297-7664

Fax: (818)338-1100 Lic# 01773119 5683 Kanan Road, Agoura Hills,