Allan and Jennifer Dute
800 Asbury Road
Cincinnati, OH 45255
513-232-1355 (voice and fax)
Rental Apartment Application
Applicant information: (REQUIRED FOR CREDIT REPORT)- COST $15 per person.
Applicant #1
Social Security # ____-___-______ Date of birth: ___/___/____
Name: ________________________________phone number (___)___________
Current Address: __________________________________________________
Amount of monthly rent paid: $________How many years have you lived here?___
Previous landlords name: ___________________ phone number (____) ________
Employer: _______________________ Manager's Name: __________________
Employer's phone number (____)_________________ Occupation ___________
How long have you worked here? ________ Wages per hour/Salary $__________
Have you EVER been asked to move? (date) _________
Have you EVER filed for bankruptcy? (date) _________
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Applicant #2
Social Security # ____-___-______ Date of birth: ___/___/____
Name: ________________________________phone number (___)___________
Current Address: __________________________________________________
Amount of monthly rent paid: $________How many years have you lived here?___
Previous landlords name: ___________________ phone number (____) ________
Employer: _______________________ Manager's Name: __________________
Employer's phone number (____)_________________ Occupation ___________
How long have you worked here? ________ Wages per hour/Salary $__________
Have you EVER been asked to move? (date) _________
Have you EVER filed for bankruptcy? (date) _________
_______________________________________________________________
I hereby authorize Allan and Jennifer Dute to obtain information regarding my past credit and or/tenant-landlord history. I hereby authorize any of the following sources, including but not limited to landlords, public or privately owned utilities, current or past creditors, governmental housing agencies, employers, police, and/or tenant-landlord history, and/or employment history and/or police history. I hereby release any of the above sources and their officers, agents or employers from any liability for damages of whatsoever kind or nature whether caused by negligence or otherwise which may at any time result to me by reason of complicity with the above mentioned inquiry which may include answering of specific questions and the giving of any information concerning my past record. I understand that false information will result in immediate rejection and loss of my application fee.
Signature: Applicant #1 ___________________________________
Applicant #1 Printed name: ____________________________ date: ______
Signature: Applicant #2 ___________________________________
Applicant #2 Printed name: ____________________________ date: ______
Relationship to Applicant #1: ________________