Rental Application

Move In Date

Your Name (required)

Your Email (required)

Phone (required)

Date of Birth

PLEASE CALL US WITH THIS INFORMATION

Social Security Number

PLEASE CALL US WITH THIS INFORMATION

Current Address (City, State & Zip)

Landlord/APT. Name (required)

Landlord Phone (required)

Own or Rent

ownrent

Monthly Rent

How Long (required)

Previous Address (City, State & Zip)

Landlord/APT. Name

Landlord Phone

Own or Rent

ownrent

Monthly Rent

How Long

Vehicle (Year, Make & Model)

Driver's License # & State of Issue

EMPLOYMENT INFORMATION

Current Employer (required)

Employer Address (City, State & Zip)

How Long (required)

Phone (required)

Email

Position (required)

Annual Income (required)

Previous Employer (required)

Address (City, State & Zip)

How Long (required)

Phone (required)

Email

Position

Annual Income

EMERGENCY INFORMATION

Name of person not residing with you. (required)

Address (required)(City, State & Zip)

Relationship

Phone (required)

NAMES OF ALL OTHER PERSONS TO OCCUPY PREMISES (ROOMMATES/CHILDREN)

Name & Age

Name & Age

Name & Age

REFERENCES

Name (required)

Address(required)

Phone (required)

Name

Address

Phone

Name

Address

Phone

The above named individual hereby applies for an apartment unit and warrants that the above statements are true and correct. Authorization is given for direct contact with references and for verification of any information obtained from any source, including credit bureaus. By checking the box below, you are agreeing that there is a $35.00 charge for each credit report obtained by Villa Pacific Properties. An Apartment Holding Fee of $_______________ is acknowledged as received. The above named individual has forty-eight (48) hours within in which to withdraw this Rental Application and request a refund of the Apartment Holding Fee, less credit report charges if completed. If such request is not made within said FORTY-EIGHT (48) hours, the fee is NON-REFUNDABLE.

Check this box once you have filled out all of the required information and you have read and understand all statements above.