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Apartment Rental Application
Accessibility Statement
DALE RESIDENCES RENTAL APPLICATION
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1. Legal Name
First Name
Middle Name
Last Name
Other Names Used
Soc Sec #
DOB
Dr Lic #
State
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Applicant Phone #
E-Mail Address
Facebook Link
Spouse
First Name
Middle Name
Last Name
Other Names Used
Soc Sec #
DOB
Dr Lic #
State
Applicant Phone #
E-Mail Address
Facebook Link
2. Current Address
Address
Landlord Phone #
City
State
Zip Code
Landlord Address
How Long
Current Rent
Has proper notice been given?
Yes
No
Current Landlord/Mortgage Lender
Reason for Moving
3. PREVIOUS ADDRESS
Rental Address/Zip Code
Dates Occupied
Landlord
Landlord Phone
Previous Landlord Address
4. 1ST PERSON INCOME
Current Employer
Employer Address/Zip
Phone #
Job Title
Date Employed
Name of Supervisor
Gross Income /year
$ /month
5. SPOUSE INCOME
Current Employer
Employer Address/Zip
Phone #
Job title
Date Employed
Name of Supervisor
Spouse Gross Income /year
$ /month
Other Income: Source
Amount $ /month
6. LEGAL NAMES OF ALL PEOPLE THAT WILL OCCUPY UNIT INCLUDING YOURSELF AND MINORS
Names
Relationship
Age
Name
Relationship
Age
Name
Relationship
Age
7. PERSONAL HISTORY
Have you ever been charged with or convicted of a felony?
Yes
No
If yes, what year and city/county?
Are you a registered sex offender?
Yes
No
Do you have a pet?
Yes
No
If yes, what kind
Weight
We require a photo & vet verification of breed letterĀ for all dogs
If dog, what breed
Have you been asked to move out or been evicted?
Yes
No
If yes, what year?
If you answered yes to any of these questions, please explain:
8. IN CASE OF EMERGENCY NOTIFY:
Name
Address
City
State
Zip
Phone (h)
(w)
(c)
Relationship
9. VEHICLE(S)
Make/Model
Year
Color
Lic Plate #
Make/Model
Year
Color
Lic Plate #
Submit