Rental Application

RENTAL APPLICATION The undersigned hereby makes an application to rent the property located at: __________12237 Wolff Place, Broomfield, CO 80020 __________________________. Anticipated move date of ___________________at a monthly rent of $_______________ and security deposit of $_______________.

PLEASE TELL US ABOUT YOURSELF Full Name______________________________________________ Home Phone (

) ___________________

Date of Birth__________________________________ Social Security #________________________________ Email Address:____________________________________(optional)

Other Phone (

) _________________

Co-Applicant Name_______________________________ Names of Dependents_________________________ Co-Applicant Date of Birth______________________ Social Security #_________________________________ Dependents Date of Birth______________________________________________________________________ List All Pets_________________________________________________________________________________ *NOTE: No pets are allowed at any time on the premises without prior Management consent and payment of fees. NO EXCEPTIONS. Other persons, including children who will live in the dwelling unit Name_______________________________________ Name ________________________________________ Name_______________________________________ Name ________________________________________ PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS) Current Address: _________________________________ City__________________ State______ Zip________ Month/Year Moved In______________________ Rent / Mortgage $__________ Reasons for Leaving__________________________________________________________________________ Owner/Agent ______________________________________________Phone (

) ______________________

Previous Address (last 3 years)___________________________________Rent / Mortgage $________________ Owner/Agent______________________________________________ Phone (

) ______________________

PLEASE DESCRIBE YOUR CREDIT HISTORY Have you declared bankruptcy in the past seven (7) years?

Yes [ ] No [ ]

If yes, explain ___________________________________________________________. Have you ever been evicted from a rental residence?

Yes [ ] No [ ]

If yes, explain ___________________________________________________________. Have you had two or more late rental payments in the past year?

Yes [ ] No [ ]

If yes, explain ___________________________________________________________. Have you ever willfully or intentionally refused to pay rent when due?

Yes [ ] No [ ]

If yes, explain ___________________________________________________________. Have you ever been convicted of a crime, other than a traffic violation?

Yes [ ] No [ ]

If yes, explain ___________________________________________________________. Have you ever had a foreclosure / repossession?

Yes [ ] No [ ]

Date _________f yes, explain ______________________________________________. PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION Your Status: _____Full Time _____Part Time _____Student _____Unemployed Employer___________________________________________________________________________________ Dates employed_______________________________ Employed as___________________________________ Supervisor Name______________________________________________ Phone (

)___________________

Salary $_________________per________________. (If employed by above less than 12 months, give name & phone of previous employer or school:___________________________________________________________.) If you have other sources of income that you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider it in this application. Amount $___________________ Source/Contact Name_____________________________________________ PLEASE LIST YOUR REFERENCES Banking Accounts: Bank Name_________________ Type of Account_________________ Account Number_________________ Approx. Balance $____________ Bank Name_________________ Type of Account_________________ Account Number_________________ Approx. Balance $____________ Other Active Credit References: Institution Name______________ Type of Account_________________ Account Number_________________ Exp. Date ______________ Credit Limit $___________ How long _______ Are all payables current? ________ Other Active Credit Ref._________ Type of Account_________________ Account Number_________________ Exp. Date ______________ Credit Limit $___________ How long _______ Are all payables current? ________ Personal Reference or Emergency Contact: Name _______________________ Address _______________________________________________ Phone _______________________ Relationship_______________________ Name _______________________ Address _______________________________________________ Phone _______________________ Relationship_______________________ Name _______________________ Address _______________________________________________ Phone _______________________ Relationship_______________________

Driver's License: Your Driver's License Number____________________________ State_________________ Vehicle Information: Make / Model _________________Year _________________License Plate State_________________ Make / Model _________________Year _________________License Plate State_________________ Make / Model _________________Year _________________License Plate State_________________

ADDITIONAL INFORMATION: Please give any additional information that might help owner/management evaluate this application? ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Where may we reach you to discuss this application? Day Phone # (

) ___________________________ Night Phone # (

)__________________________

Date of desired occupancy ______________________Anticipated length of stay ________________________ Do you own: Vacuum cleaner [ ] Lawn mower [ ] Waterbed [ ] Musical inst. [ ] Smoker Yes [ ] No [ ] A non-refundable application fee of $__30_____ and a deposit of $_________ are required for processing this application, and is being paid herewith. The undersigned expressly agrees that if this application is approved applicant herewith agrees to rent this property. Applicant further agrees that if applicant is accepted by Management or owner and then decides not to move into the premises, then all monies paid herewith shall be retained as liquidated damages since other prospective tenants may have been turned away and it may be necessary for Management or owner to re-advertise the property and evaluate other applicants. Processing of application shall be as timely as possible and the results may be delivered via telephone, fax or mail. Once approved, applicant agrees to pay the balance of funds and complete the paperwork within 48 hours, otherwise management or owner will assume that applicant has decided to forfeit the reservation/earnest money payment made herewith and will begin re-marketing the property. If applicant is not approved, all monies given herewith, less application fee shown above shall be returned to the applicant. Upon acceptance, this deposit shall be retained as part of the security deposit. I hereby deposit $___________ as earnest money to be refunded to me if this application is not accepted in 3 business banking days. Upon acceptance, this deposit shall be retained as part of the security deposit. When so

approved and accepted, I agree to execute a lease for ___________ months before possession is given and to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental 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 statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application. A PHOTOSTATIC COPY OF MY DRIVER’S LICENSE OR PICTURE ID CARD, SOCIAL SECRUITY CARD, LATEST PAY CHECK STUB(S) AND LAST YEAR’S W-2 (s) OR COPY OF LAST YEARS INCOME TAX RETURN ARE ATTACHED TO THE APPLICATION ( ), OR WILL BE PROVIDED ( ). I declare that the application is complete, true and correct and I herewith give my permission for anyone contacted to release the credit or personal information of the undersigned applicant to Management or their authorized agents, at any time, for the purposes of entering into and continuing to offer or collect on any agreement and/or credit extended. I further authorize Management or their Authorized Agents to verify the application information including but not limited to obtaining criminal records, contacting creditors, present or former landlords, employers and personal references, whether listed or not, at the time of the application and at any time in the future, with regard to any agreement entered into with Management. Any false information will constitute ground for rejection of the application, or Management may at any time immediately terminate any agreement entered into in reliance upon misinformation given on this application. The above information, to the best of my knowledge, is true and correct.

Please sign: X__________________________________

__________________________________

Name of Applicant

Date

Please sign: X__________________________________

__________________________________

Name of Co-Applicant

Date

AUTHORIZATION Release of Information

I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house from this owner/manager. _____________________________________________ Name (please print) X_______________________________________ Signature

__________________________ Date

APPLICANT: PLEASE DO NOT WRITE BELOW (FOR OFFICE USE ONLY) Deposit of $__________________ Received by ____________________________ Date_______________ OFFICE NOTES: