Lost Mountain Real Estate

Rental Application

Application must be presented with deposit

Property

Projected Move In Date

1^st Applicant Name (Last, First, MI)

DOB (MM/DD/YY)

Social Security #

Street Address

Home Phone

(             )

City, State, Zip

No. of Dependants

2^nd Applicant Name (Last, First, MI)

DOB (MM/DD/YY)

Social Security #

Landlord Name

Years at Address

Reason for moving?

Have you given notice yet?

Previous Landlord Name

Years at Address

Reason for moving?

Current Employer

Address

Position

Years

Contact Person / Supervisor

Phone

(              )

Gross Monthly Salary

Other Income

Source of Other Income

Total Gross Income

Previous Employer

Address

Position

Years

Contact Person / Supervisor

Phone

(              )

Have you ever filed bankruptcy? 

If so, explain:

Have you ever been served an eviction notice or been asked to vacate a property you were renting?

If so, explain:

Have you willfully or intentionally refused to pay rent when due?

If so, explain:

Have you ever been convicted of a crime other than a minor traffic offense?

If so, explain:

Have you ever had a judgment entered against you?

If so, explain:

Contact in Case of Emergency / Relationship

Emergency Phone

Please list the following vehicles you will store at this property:

Make

Model

Color

Year

License #

1.

2.

3.

4.

I authorize Lost Mountain Real Estate, and/or their assignees, to perform a background and/or credit check based on the information provided. No application will be processed without a deposit equivalent to one month’s rent.  All applications will be either approved or denied, normally within three business days of submission. 

Applicant Signature

Date

Co-Applicant Signature

Date

By submitting this application / deposit, you commit to lease the subject property for no less that 12 months, if approved.

 
If we deny your application, your security deposit will be refunded immediately. If your application is approved and you elect, for any reason, not to enter into a lease on the subject property, you will forfeit as damages 100%of the deposit.

Applicant Signature

Date

Co-Applicant Signature

Date