Application
Home & Property Management L.L.C.
1655 Riverton Rd. #6
P.O. Box 786
Blackfoot, ID 83221
208-785-3560 (Fax & Phone)
wjpotter2@msn.com


The undersigned hereby makes application to rent unit number____ located at______________________ Beginning on _______________________, at a monthly rental of $______________.

PLEASE TELL US ABOUT YOURSELF

FULL NAME______________________________________Phone (____)________________

Date of Birth_________________________Social Security No.________________________

Name of Co-Applicant_________________________________________________________

Number of Dependents (excluding Co-Applicant)________________

Other Occupants_____________________________________________________________

Pets (Number and Kind)_______________________________________________________

RESIDENCE HISTORY FOR THE PAST 3 YEARS (Beginning With Most Current)

CURRENT ADDRESS___________________________________________

Month &Year Moved ln_______Reason for Leaving______________________________

Owner or Agent________________________________________Phone(___)___________

PREVIOUS ADDRESS (If within 3 years)_______________________________________

Month &Year Moved In____Moved Out____Reason for Leaving___________________

Owner or Agent________________________________________Phone(____)__________

PREVIOUS ADDRESS (If within 3 years)_______________________________________

Month &Year Moved In____Moved Out____Reason for Leaving___________________

Owner or Agent________________________________________Phone(____)__________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

PLEASE GIVE YOUR EMPLOYEE INFORMATION

YOUR STATUS: [ ] Full-Time [ ] Part-Time [ ] Student [ ] Retired [ ] Unemployed

EMPLOYER _____________________________________________________________

Date(s) Employed____________Employed as_______________________________________

Supervisor______________________________ Supervisor's Phone(____)_______________

Address_______________________________________________________________________

Salary $___________per______If employed by above less than 6 months, give name and address of Previous Employer or school_______________________________________

If there are other sources of income you would like us to consider, please list income, source and person (Banker, Employer, etc.) who we could contact for confirmation. You do NOT have to reveal alimony, child support or spouse's annual income unless you want us to consider it in this application.

Amount $_____________Source________________________________________________

HAVE YOU EVER: Filed for bankruptcy? [ ] No [ ]Yes

Been evicted from tenancy? [ ] No [ ] Yes

Willfully or intentionally refused to pay rent when due? [ ] No [ ] Yes

Personal References:

1.___________________________________________________Phone (____)__________

2.___________________________________________________Phone (____)__________

3.___________________________________________________Phone (____)__________

4.___________________________________________________Phone (____)__________

If management has any questions about this application, please give PHONE NUMBERS where you can be located:

DAY PHONE(S)__________________________________

NIGHT PHONE(S)________________________________

___________________________________________________________________________

___________________________________________________________________________

I hereby apply to lease the above described premises for the term and upon the conditions above set forth and agree that the rental is to be payable the 1st day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application, I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, $100.00 of the deposit will be retained to offset the agent's cost, time, and effort in processing my application.

I hereby deposit $ ______________ as earnest money to be refunded to me if this application is not accepted within __________ business banking days. Upon acceptance of this application, this deposit shall be retained as part of the security deposit. When so approved and accepted I agree to execute a lease for a minumum of six months before possession is given and to pay the balance of the security deposit before taking possession, after being notified of acceptance, or the deposit will be forfeited as liquidated damages in payment for the agent's time and effort in processing my inquiry and application, including making necessary investigation of my credit, character, and reputation. If this application is not approved and accepted by the owner or agent, the deposit will be refunded, the applicant hereby waiving any claim for damages by reason of nonacceptance which the owner or his agent may reject without stating any reason for so doing.

The above information, to the best of my knowledge, is true and correct.

Signature of Applicant_____________________________Date Signed_______________

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Home & Property Management L.L.C.
Weston Potter
1655 Riverton Rd. #6
P.O. Box 786, Blackfoot, ID 83221
wjpotter2@msn.com

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