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    Patrick Sullivan
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    Shamrock rental application

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    Shamrock rental application

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    35 views4 pages

    Rental Application

    Uploaded by

    Patrick Sullivan
    Shamrock rental application

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 4

    Shamrock-Shamrock, Inc.

    Rental Application

    Applicant Information
    Applicants Name ________________________________________________________
    Applicants Date of Birth ___ / ___ / ___
    Applicants Social Security Number ______-____-_______
    Work Phone (____)_______________ Home/Cell Phone (____)_______________
    E-Mail Address __________________________________________________________
    Drivers License Number __________________________________________________
    Present/Former Address
    Address ________________________ City ______________ State ____ Zip ______
    Rent Amount $___________ Dates Lived at Address __________ to __________
    Reason for leaving ________________________________________________________
    Landlord/Owner Name _________________________ Telephone _________________
    Former Address (if current is less than two years)
    Address ________________________ City ______________ State ____ Zip ______
    Rent Amount $___________ Dates Lived at Address __________ to __________
    Reason for leaving ________________________________________________________
    Landlord/Owner Name _________________________ Telephone _________________

    Employment
    _______________________________________________________________________
    _
    Employer
    Telephone
    _______________________________________________________________________
    _
    Supervisor
    Your Position
    Employed _________ to _________ Full-time ___ Part-time ___ Salary/Wage _____
    Former Employer (if current is less than two years)
    _______________________________________________________________________
    _
    Employer
    Telephone
    _______________________________________________________________________
    _
    Supervisor
    Your Position
    Employed _________ to _________ Full-time ___ Part-time ___ Salary/Wage _____
    Other source of income ___________________________________________________
    Vehicle Information
    Make & Model of Vehicle: ______________________________ Tag: ______________
    Make & Model of Vehicle: ______________________________ Tag: ______________
    Make & Model of Vehicle: ______________________________ Tag: ______________
    Miscellaneous Questions

    Do you have pets? Yes No What type? _____________________________________


    *** Please note: there may be additional deposits and/or fees required for tenants who have pets***

    Have you ever declared bankruptcy? Yes No If so, when? ______________________


    Has an eviction ever been filed against you? Yes No If so, when? ________________
    Have you ever been convicted of a felony?

    Yes No If yes, please explain below:

    _______________________________________________________________________
    _
    _______________________________________________________________________
    _
    Emergency Contact (who can we contact in case of an emergency)
    Name _______________________________ Relationship _______________________
    Address ________________________ City ______________ State ____ Zip ______
    Home Phone _____________ Cell Phone _____________ Work Phone ____________
    Name _______________________________ Relationship _______________________
    Address ________________________ City ______________ State ____ Zip ______
    Home Phone _____________ Cell Phone _____________ Work Phone ____________
    List of Tenants
    Name ___________________ Age _____ Name ___________________ Age _____
    Name ___________________ Age _____ Name ___________________ Age _____
    Name ___________________ Age _____ Name ___________________ Age _____
    Personal References

    Name ___________________ Relationship _____________ Phone _______________


    Name ___________________ Relationship _____________ Phone _______________
    Name ___________________ Relationship _____________ Phone _______________
    I hereby certify and affirm that all information provided above is true and correct. I fully
    understand that my lease or rental agreement may be terminated if I have made any false,
    misleading, or incomplete statements in this application. I hereby authorize verification
    of all information provided in this application, including financial and credit information,
    via credit bureaus and/or contact with current and previous employers, current and
    previous landlords, and personal references.
    Applicant ____________________________________ Date _____________________

    Please send rental application to:


    Shamrock-Shamrock, Inc.
    P.O. Box 227
    Daytona Beach, Florida 32115
    Or fax to: (386) 304-7709

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