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Property address
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Length of lease
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Desired occupancy date
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Applicant Name:
Date of Birth:
Social Security #:
Drivers License #:
include state:
If none, enter "None"
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Co-Applicant Name
Date of Birth:
Social Security #:
Drivers License #:
include state:
If none, enter "None"
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Name(s) of other occupants
(If none enter "none")
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Pets (If yes, specify type. If cats or dogs,
include ages and weights)
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Do any of the applicants or other
occupants smoke? (yes or no)
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Present address
Street:
City:
State:
Zip code:
How long have you lived there:
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Home phone
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Work phone
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Cell phone
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Applicant's email address
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Present landlord/mortgage company
Name:
Phone #:
Monthly rent/mortgage payment:
"Rent" Or "Own"
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Previous address (if less than 2 years ago)
Street:
City:
State:
Zip code:
How long did you live there:
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Previous landlord/mortgage company
Name:
Phone #:
Monthly rent/mortgage payment
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Applicant's employer
Name of employer:
Employer's address:
Position:
Monthly income:
Supervisor:
Supervisor's phone #:
How long have you been employed there:
Subject to transfer:
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Co-Applicant's employer
Name of employer:
Employer's address:
Position:
Monthly income:
Supervisor:
Supervisor's phone #:
How long have you been employed there:
Subject to transfer:
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Have you ever been evicted from any leased
property? (Yes or No) If yes, what was the
reason.
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Nearest relative:
Name:
Relationship:
Address:
Phone #:
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Security Deposit Agreement
Applicant agrees to pay a security deposit, receipt of which is acknowledged as an interest bearing
deposit and not as a rental payment. This deposit will be applied as a security deposit if the rental
agreement is executed, or retained by the property manager to cover the cost of taking and processing
the application should, through no fault of the property manager, the applicant fail or refuse to occupy
the premises on the agreed upon date of occupancy. In the event this application is not approved or for
any reason the rental agreement is not executed, this deposit will be refunded. However, if costs are
incurred in checking out-of-town references, this cost will be deducted from the deposit. Where pets
are permitted, a deposit shall be paid by the applicant which is non-refundable.
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Enter "Agree" or "Disagree"
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Credit Check
WE HEREBY AUTHORIZE HENRY PROPERTY MANAGEMENT AND/OR A THIRD PARTY TO
CONTACT THE CREDIT BUREAU FOR VERIFICATION OF OUR CREDIT HISTORY. There is a
non-refundable application fee of $75. This fee can be paid by credit card, either by phone or
online by filling out the fields below.
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Name as it appears on your credit card
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Billing address
Street:
City:
State:
Zip code:
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Credit card number (if paying by
phone enter "phone")
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Credit card type (Mastercard or
Visa only)
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Credit card expiration date
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This application is made with the understanding that it is subject to acceptance and execution of
the rental agreement covering said premises.
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Enter "Agree" or "Disagree"
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Name of Showing Agent
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