Social Security Number

Driver's License No.    Phone

Other Residents    Social Security No.

Other Residents    Social Security No.

Other Residents    Social Security No.

RESIDENT'S HISTORY

Present Address    City, State, Zip

How Long?

Present Landlord    Phone

Reason for Moving    Rent

Previous Address    How Long?

Previous Landlord    Phone

Reason for Moving    Rent

EMPLOYMENT INFORMATION

Employer    Starting Date

Address

Position Held    Monthly Income

Supervisor    Phone

Other Employment
Employer    Starting Date

Address

Position Held    Monthly Income

Supervisor    Phone

OTHER INCOME

Source    Amount

Agency Contact    Phone

CREDIT REFERENCES

Bank    Type of Account

Bank    Type of Account

OTHER INFORMATION

Automobiles and Other Vehicles

Make    Year    Color    Lic. No.

Make    Year    Color    Lic. No.

Emergency Contact

In case of personal emergency, notify    Relationship

Address    Phone

History

Have you ever been evicted or been served an eviction notice?   Yes   No
Have you ever filed for bankruptcy?   Yes   No
Have you ever been arrested or convicted for anything other than a traffic offense?   Yes   No

If you are obtaining all or part of your living expenses from a parent or guardian, you must include the following information:

Name    Relationship

Address    Phone

AUTHORIZATION

My rental of said premises is to be limited to use and occupancy by family of size and description above without any right on my part to sublet all or any of the said premises. I authorize you to contact any references that I have listed.

I agree to the terms and conditions as stated above   Yes   No

Initials to agreement    Date

PLEASE NOTE: THIS IS ONLY AN APPLICATION. IN THE EVENT THIS APPLICATION IS APPROVED FOR RENT, A SECURITY DEPOSIT IS REQUIRED FROM EVERY TENANT AGAINST DAMAGE OR LOSS TO THE PREMISES, AND SAID SECURITY DEPOSIT CANNOT BE USED FOR THE LAST MONTH'S RENT

CREDIT AUTHORIZATION

I (we) hereby authorize the landlord (Swanson Realty) and any consumer or credit reporting agency, company, or bureau authorized by it to investigate now and at any time during which a lease I (we) sign affects my (our) credit history and responsibility and any and all statements, whether written or oral, made with the rental application of the undersigned. The above parties are further given permission and authorization to investigate, inquire of, and contact any persons or organizations named in the application, and to make a consumer credit report setting forth the finds of the above authorized investigation. The above named parties are further authorized to report my (our) performance under this lease to any and all such agencies, persons, organizations, or future landlords of the undersigned. I (we) understand that these parties include but are not limited to present landlord, previous landlords, current employer, future employer, and financial institutions.

The above parties reserve the right to investigate or not to investigate any one or more of the undersigned. The undersigned further release and agree to hold harmless Swanson Realty and its employees for and from any and all errors, mistakes, and or other violations the fault of which can be attributed to a credit reporting agency, company, or bureau of any other third party.

**PLEASE READ CAREFULLY BEFORE SIGNING**

Full Name

I agree to the terms and conditions as stated above   Yes   No

Initials to agreement    Date