Rental Application
RENTAL APPLICATION
DEL CO & CT Properties.
DeLisle Real Estate Company
Please Print
APPLICANTS NAME:
First________________________.Middle_______________________Last_____________________________.
Social Security Number._________________________________. Date of Birth_________________________.
Drivers License/State ID No:__________________________________________________________________.
Telephone Numbers.
Home_____________________________________. Mobil__________________________________________.
Work_____________________________________ .Other__________________________________________.
Email Address______________________________________________________________________________.
PRESENT ADDRESS:
__________________________________________________Apartment No____________________________.
City____________________________State___________________________Zipp code___________________.
Rental Dates.____________________to______________________.Rental amount______________________.
Reason for moving.__________________________________________________________________________.
PROPERTY OWNERS NAME/ADDRESS/TELEPHONE:
Name________________________________________Address______________________________________.
Telephone No______________________________________________________________________________.
PRIOR ADDRESS:
___________________________________________________Apartment No___________________________.
City___________________________State___________________________Zipp code____________________.
PRIOR PROPERTY OWNERS NAME/ADDRESS/TELEPHONE:
Name_______________________________________Address___________________________________________.
Telephone No__________________________________________________________________________________.
Rental Dates____________________to________________________.
EMPLOYMENT INFORMATION:
Name_______________________________________.Address___________________________________________.
Telephone No:________________________________.Salary____________________________________________.
Job description ________________________________. Hours per week___________________________________.
OTHER INCOME: SSI/State Funds/Other:
What_____________________________________Monthly Amount_______________________________________.
Case Worker_______________________________Telephone number_____________________________________.
VEHICLE INFORMATION:
Make________________________________License______________________Year_________________________ .
PERSONAL INFORMATION:
Do you have a bank account : No________Yes___________Where_________________________________________________________.
Have you every filed bankruptcy: No_______Yes___________When________________________________________________________.
Have you ever been evicted or asked to move: No_________Yes_________When_____________________________________________.
Why____________________________________________________________________________________________________________.
Have you ever withheld rent: No__________Yes____________When_______________________________________________________.
Why____________________________________________________________________________________________________________.
Have you every been convicted of a Misdemeanor/Felony: No_________Yes______________When_______________________________.
Why____________________________________________________________________________________________________________ .
Do you have a legal right to be in the United States: Yes__________________No_______________________.
If No give Valid Reason:______________________________________________________________________.
I the undersigned do hereby authorize an agent of Del Co (The owners) or an authorized representative to verify the information provided in this document,
I further authorize then to check my credit, criminal history, civil history or any other public or private documents, that will assist them in determining my application.
I further agree that if I have filled out document unfaithfully that I may forfeit all or part of any security deposit. And that by signing this document,
that it may be provided to and used as a release for information. This document will expire in one year from date of signing,
Dated This Day_________________________BY_______________________________________________.
Dated This Day_________________________BY_______________________________________________.
___________The following__________Application fee in the amount of $35.00 has been paid.
Amount that has been paid toward the security deposit $_______________.
For a deposit on the following Apartment_________________________Rental Amount $____________________ .
Move in date __________________________________For a lease of_____________________________________.
