Rental Application

As part of Bluff Park Realty verification process, be prepared to provide copy of driver's license & most recent pay stub.

Personal Information

First Name

Middle Name

Last Name

Suffix

Date of Birth

Soc. Sec. No.

DL State

Driver Lic No

Cell Phone

Work Phone

Other Phone

Email Address

Bank Name (Checking)

Location Applied For

Location Applying For

Rent

Deposit

Pets/type

Date Occupancy
Desired

Nbr. Persons
to Occupy Unit

When do you need to be
out of current residence?

List Occupants

Age

Sex

List Occupants

Age

Sex

Rental History

Current Address

City

State

Zip Code

From (Date)

To (Date)

Monthly Rent/Pmt

Reason for Moving

Notice Given

Property Manager Name

Prop Mgr Phone

Previous Address

City

State

Zip Code

From (Date)

To (Date)

Monthly Rent/Pmt

Reason for Moving

Notice Given

Property Manager Name

Prop Mgr Phone

Previous, Previous Address

City

State

Zip Code

From (Date)

To (Date)

Monthly Rent/Pmt

Reason for Moving

Notice Given

Property Manager Name

Prop Mgr Phone

Employment History

Current Employer

City

State

Zip Code

Supervisor's Name

Supervisor Phone

Date Hired

Position

Gross Monthly Pay

Net Monthly Pay

When Paid

Previous Employer

City

State

Zip Code

Supervisor's Name

Supervisor Phone

Start Date

End Date

Position

Gross Monthly Pay

When Paid

Notice Given

Previous, Previous Employer

City

State

Zip Code

Supervisor's Name

Supervisor Phone

Start Date

End Date

Position

Gross Monthly Pay

When Paid

Notice Given

General Information

1. Have you ever been evicted? If so, When?

2. Have you ever had a part of your deposit not refunded?

3. Are you/anyone in family a convicted sex offender?

4. If needed, do you have someone that would co-sign on your lease? Relationship?

5. How many times in the past year have you had?

Payday Loan

Bounced Check

Rent Paid Late

Rented Furniture

6. How do you pay your rent (check all that apply)?

Vehicle Information

Make

Model

Year

Color

Tag No

Loan Bal

Emergency Contact Information

Emergency Contact

Phone

Relationship

Giving false information on this application will result in your lease being terminated. I certify that the above information is true and correct and authorize you to obtain necessary credit/criminal/and employment verification or character information at anytime, now or for future purposes.
I agree

Applicant Signature

Date

Application Date