RENTALS APPLICATION FORM
RESIDENTIAL RENTAL APPLICATION
Landlord Address
Landlord Name: Cindy Jussila
Rental Property Information
Rental Property Address:11403 E 2nd Ave #15, Spokane, WA 99206
Anticipated Possession Date: ______________________ _______, ________
.
The monthly rent will be $1000
The security deposit will be $800
Applicants' Personal Information
Applicant's Name:
Home Phone: ( ) Alternative Phone: ( )
Email Address (Optional): Date of Birth:
Second Applicant's Name:
Second Applicant's Date of Birth:
Third Applicant's Name:
Third Applicant's Date of Birth:
Dependants Name(s): Date(s) of Birth
Do you have a pet? Yes / No If more than one, how many? _______
Please describe type(s) of pet(s):
Residential History
Present Address:
City: State:
ZIP Code: How long at this address?
Landlord / Lessor: Phone: ( )
Previous Address 1:
City: State:
ZIP Code: How long at this address?
Landlord / Lessor: Phone: ( )
Previous Address 2:
City: State:
ZIP Code: How long at this address?
Landlord / Lessor: Phone: ( )
Details of Employment
Employer:
Position: Date Hired:
Supervisor's Name: Phone: ( )
Salary:
(If employed less than one year with present employer, please provide previous
employer.)
Previous Employer:
Position: Date Hired:
Supervisor's Name: Phone: ( )
Salary:
Other Sources of Income
Do you receive income from any of the following sources? Yes / No
Student Loans ______ Pension Benefits ______ Social Assistance ______ Other ______
Please provide contact persons who could verify the amount of income you receive:
Vehicle Information
Make / Model: Year:
License Plate Number: Driver's License Number:
Make / Model: Year:
License Plate Number: Driver's License Number:
Parking stall required? Yes / No Additional stall required? Yes / No (Subject to
availability)
Banking Information
Banking Institution:
Address:
Phone: ( )
(If you bank with more than one institution, please list second bank below)
Banking Institution:
Address:
Phone: ( )
References
Name: Phone: ( )
Name: Phone: ( )
Emergency Contact
Name:
Relationship: Phone: ( )
Criminal & Credit Background Check Authorization
Is there anything negative that we may find in our criminal or credit background check
that you want to comment on?
I declare that the information I have provided is accurate. I authorize the individual or
organization to which this application is submitted to: (a) contact my references and all
other persons that I have named in this application; and (b) perform a credit and/or
criminal check to assess my suitability as a tenant/lessee.
Applicant's Signature ___________________________ Date _________________
Landlord : Cindy Jussila Tenant:
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Tenant Signature