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Licking County Permeir Renal Properties
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Homes For Rent
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Pet Policy
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Maintenance Request
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Address Applying for
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Desired Move-In Date
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MM
DD
YYYY
Important Note to Applicants
The monthly rent shall be due on the 1st day of occupancy (prorated if necessary) and the 1st of the month thereafter. The security deposit shall be due at signing of the lease agreement. Please fill this application out in full. Incomplete applications will be sent back to you to complete, causing a delay in the process and decreasing your chances of renting from us.
First Name
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Middle Name
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Last Name
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Date of Birth
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MM
DD
YYYY
Phone
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(###)
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Alternate Phone
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(###)
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Email
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Who else will be living with you?
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Rental History
Please include all addresses you have lived at for the previous 5 years.
Current Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Move-in Date
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Landlord’s Name
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Landlord’s Phone
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(###)
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Monthly Rent
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Reason for Moving
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Previous Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Move-in Date
*
MM
DD
YYYY
Move-out Date
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MM
DD
YYYY
Landlord’s Name
*
Landlord’s Phone
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(###)
###
####
Monthly Rent
*
Reason for Moving
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Previous Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Move-in Date
*
MM
DD
YYYY
Move-out Date
*
MM
DD
YYYY
Landlord’s Name
*
Landlord’s Phone
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(###)
###
####
Monthly Rent
*
Reason for Moving
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Employment Information
Please include all sources of income. If Self-employed: Please supply tax returns for previous two years and two most recent banks statements.
Current Employer
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Position
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Employer Phone Number
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(###)
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Supervisor Name
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Gross Wages Per Month
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Hire Date
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MM
DD
YYYY
Other Sources of Income
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Amount Per Month
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If you have other sources of income. Explain
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Questionnaire
Please answer all these questions truthfully
How long will you live here?
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What pets do you have?
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How many evictions have been filed upon you?
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How many felonies do you have?
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Have you ever broken a lease?
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Do You Smoke?
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How many vehicles do you own?
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Is the total move-in amount available now?
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When would you like to move in?
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How did you hear about this home?
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Do you have a checking account?
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Do you have a savings account?
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Emergency Contact -Name
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Phone
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Relationship
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Why should we rent to you?
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Additional Information
Please use this optional space for additional information, comments, or explanations.
Authorization
Applicant authorizes the Landlord or Landlord’s representatives to make any inquires deemed necessary to verify Applicant is the most qualified based on the below stated qualification standards. This verification includes, but is not limited to, direct contact with Applicant’s employers, current landlord, previous landlords, friends, personal and professional references, law enforcement agencies, government agencies, consumer reporting agencies, public records, eviction records, and any other sources of information which the Landlord or Landlord’s representative may deem necessary. Applicant verifies that the Landlord and Landlord’s representatives shall not be held liable for damages of any kind that result from the verification of the information provided. This authorization shall extend through Applicant’s tenancy to ensure continued compliance to the terms of tenancy or to recover any financial obligations relating to Applicant’s tenancy, and beyond the expiration of Applicant’s tenancy for recovery of any financial obligations, or for any other acceptable purpose.
Qualification Standards
Your Application will be denied if you do not meet the below standards for qualification. Applicant must have current photo identification and a valid social security number. Applicant's monthly household income must exceed three times the rent. All income must be from a verifiable source. Unverifiable income will not be considered. Applicants must receive positive references from all previous landlords for the previous 5 years. Applicant may not have any evictions or unpaid judgments from previous landlords. Applicant must exhibit a responsible financial life. Credit score must be a minimum of 600. A background check will be conducted on all applicants over 18. Applicant’s background must exhibit a pattern of responsibility. Applicant must be a non-smoker. Occupancy is limited to 2 people per bedroom.
Thank you!
