Dane

Co-signor Agreement to be attached Yes___ No ___

Email Address:_________________________________________________________________

Applicant Name: __________________________________________________ Soc. Sec.#________________________________________ Date of Birth: _____/_____/_______ Driver’s Lic. # ____________________________________ Phone#:___________________

Present Address: __________________________________________________________________ Apt#:______________________

City: _____________________________________________ State: ____________ Zip: _____________ How Long: __________________

Permanent/Parent Address: __________________________________________________________ Apt#:______________________

City: _____________________________________________ State: ____________ Zip: _____________ How Long: __________________

Pres. Landlord Name: ____________________________________________ Phone #:________________________ Rent $_____________

If less than one year, please use additional information area at bottom of page to list previous landlord.

Do you have pets? _______ How many? _________ Type, Breed & Weight __________________________________________________

NOT ALL OF OUR RENTALS ALLOW PETS. YOU MUST SIGN A PET ADDENDUM TO BE ALLOWED TO HAVE A PET PROVIDED THAT THE LOCATION YOU ARE APPLYING FOR ALLOWS PETS. THERE WILL BE A ONE TIME NON-REFUNDABLE PET FEE, DEPENDING ON THE SIZE AND TYPE OF PET YOU HAVE. PLEASE TALK TO A BRANDT COMPANY REPRESENTATIVE TO FIND OUT IF A PET IS ALLOWED AT THE PROPERTY YOU ARE APPLYING FOR.

Employer’s Name _____________________________________________________________________ Phone # _____________________

Address _____________________________________________ City ______________________ State _______ Zip ___________________

Position _________________________________________________________________________ Monthly Salary ___________________

How Long ___________ Supervisor’s Name _______________________________________________ Phone _______________________

If less than one year, please use additional information at bottom of page to list previous employer.

Additional income ____________ Source ______________________________________________________ Amount _________________

Name of Bank___________________________________________________________ Checking Account _________________________

Address _______________________________________________________________________ Phone __________________________

Credit Card # _____________________________________________________ Exp __________________Visa _______ Mastercard _____

Have you ever had a NSF? ___________ If so was it resolved? _____________________________________________________________

Have you ever been evicted? ____________ Address______________________________________________________________________

Reason ___________________________________________________________________________________________________________

Have you ever been convicted of a Felony? _________ If yes, Please Explain __________________________________________________

Additional Information ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The applicant represents that all the above statements are true and complete. The applicant hereby authorizes verification of the above information, references and credit reports. This application is a preliminary only and does not obligate the Owner or Management to execute a lease or deliver possession of the proposed premises. Our application policy is found on the back of this application and is part of the application.

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