Present Landlord: ____________________________________     Phone #: _________________/__________________   

     Monthly Rent: $______________     From: __________________  To: ________________________________________

     Current Employer: ____________________________________    From: __________________   To: ________________

     Person to Contact:______________________________________ Phone # __________________/__________________

     Monthly Gross Income $_________________________________  Other Income: (Explain)$_______________________

     Co-Applicant: ________________________________________    SSN: ___________________   DOB: _____________

     Present Address: ______________________________________  City: ____________________   St: ____  Zip ________

     Home Phone #: ______________ Cell #: ___________________     E-mail: ___________________________________

     Present Landlord: _____________________________________    Phone #:__________________/_________________

     Monthly Rent: $_____________   From: ___________________     To: ________________________________________

     Current Employer: ____________________________________    From: ___________________  to: ________________

P  Person to Contact: ____________________________________     Phone #: _________________/___________________

     Monthly Gross Income: $_______________________________     Other Income: (Explain)$_________________________

      Have you ever been evicted or broken a lease? ______________     If yes, Explain:    _______________________________

      Why are you leaving your present address: _______________________________________________________________

     List all other persons to be occupying the Premises:

     Name: __________________________ Age______________           Name: __________________________ Age_______

     Name: __________________________ Age______________          Name: __________________________ Age________

     Name: __________________________ Age______________          Name: __________________________ Age________

     Pets:  Yes or No     How Many?_______      What Kind?_____________________________     Age________________________

     Name/address/Phone#/ of nearest relation in case of Emergency:___________________________________________________

     What brought you to R& B Properties? ( ) Newspaper  ( ) Yard  Sign  ( ) Web Page  ( )  Other Realtor_________________________

      Do you (or any occupant) have a criminal record? If so explain: ____________________________________________________

     It is understood that subject property will remain on the rental market until valid lease is consummated.

     This office will  use the Equifax Credit Reporting Service to get a credit and background check regarding this application.

     If you are turned down based on your credit report, you have the right to a copy of your credit report, under the Fair Credit

     Reporting Act,  From  Equifax.  Delinquent  accounts are turned over to Credit Adjustment Bureau for collection.  

     This property is offered without respect to race, color, religion, sex, national origin, handicap, or familial status.

     Agency Disclosure: R & B Properties, Inc. serves as agent for the owner.  We are required by law to treat both parties fairly.

     APPLICANT: ___________________________________        CO-APPLICANT: _________________________________

     FINDER: _______________________________________        DATE OF APPLICATION: __________________________