APPLICANT DATA

Personal Details
First Name:		Middle Name:		Last Name:
Home Phone:		Mobile Phone:		Office Phone:
DOB: MM/DD/YY		Social Security #:
Current Residing Status
Street Address:		City, State, and ZIP:		Date Occupied:
Manager Name:		Manager Phone:		Reason for Leaving:
Previous Address Information
Street Address:		City, State, and ZIP:		Date Occupied:
Manager Name:		Manager Phone:		Reason for Leaving:
2nd Previous Address Information
Street Address:		City, State, and ZIP:		Date Occupied:
Manager Name:		Manager Phone:		Reason for Leaving:

EMPLOYMENT DATA

Current Employment Information
Employer:		Title:		Supervisor:		Phone:
Address:		City:		State:		ZIP:
Monthly Pay:		Self Employed:		From (MM/DD/YY):		To (MM/DD/YY):
Previous Employment Information
Employer:		Title:		Supervisor:		Phone:
Address:		City:		State:		ZIP:
Monthly Pay:		Self Employed:		From (MM/DD/YY):		To (MM/DD/YY):

OTHER INCOME

Other Income Source Information
Source:		Description/Account #:		Monthly Amount:

BANKING DATA

Banking Information
Bank Name:		Checking Acc #:		Savings Acc #:		Phone:
Street Address:		City:		State:		ZIP:
Credit Card Information
Name/Type:		Card #:		Expires (MM/DD/YY):

AUTOMOBILES

1st Automobile
Year:		Make:		Model:		License #:		State:		Loan Bal:		Payment:
2nd Automobile
Year:		Make:		Model:		License #:		State:		Loan Bal:		Payment:

PETS: (APPROVED PETS MUST BE INDICATED ON LEASE; ALSO $500 ADDITIONAL DEPOSIT IS DUE)

Pet Information
1st Type:		How Many?		2nd Type:		How Many?		Water Gallons of Fish-Tank (If any):

OTHER OCCUPANTS

1st Name / Personal Details
Full Name:		Relationship:		Age:
Phone:		Social Security #:		DOB (MM/DD/YY):
2nd Name / Personal Details
Full Name:		Relationship:		Age:
Phone:		Social Security #:		DOB (MM/DD/YY):
3rd Name / Personal Details
Full Name:		Relationship:		Age:
Phone:		Social Security #:		DOB (MM/DD/YY):

FAMILY NOTIFICATION: (FATHER, MOTHER, ETC)

Name / Personal Details
First Name:		Middle Name:		Last Name:
Relationship:		Home Phone:		Work Phone:
Street Address:		City, State, and ZIP:		Age:

EMERGENCY NOTIFICATION: (NEARBY FRIEND, ETC)

Name / Personal Details
First Name:		Middle Name:		Last Name:
Relationship:		Home Phone:		Work Phone:
Street Address:		City, State, and ZIP:		Age:

BACKGROUND:

Please select Yes/No for the following questions
Have you EVER been involved in LEGAL PROCEEDINGS regarding your tenancy?	Yes No
Have you EVER paid your rent late for any reason?	Yes No
Have you EVER written a BAD CHECK to pay rent?	Yes No
Have you EVER caused or been a part of a disturbance requiring POLICE intervention?	Yes No
We need your email address:
Please give us your suggestions and comments... We are always attempting to improve our website:	Comments / Suggestions go here...

READ THIS CAREFULLY BEFORE SUBMITTING YOUR APPLICATION

Everything that I have stated in this application is correct to the best of my knowledge. I realize my application may be rejected if I have failed to answer any of the questions or have given any false information. I understand that Pike Properties will retain this application, credit report, and other documents whether or not it is approved. I hereby authorize Pike Properties and or agent(s) to obtain a consumer report, and any other information it deems necessary, for the purpose of evaluating my application. I understand that such information may include, but is not limited to, credit history, civil and criminal information, records of arrest, rental history, employment/salary details, vehicle records, licensing records, and/or any other necessary information.

I hereby expressly release Pike Properties, and any procurer or furnisher of information, from any liability what-so-ever in the use, procurement, or furnishing of such various local, state and/or federal government agencies, including without limitation, various law enforcement agencies. Furthermore, I understand that there is a NON-REFUNDABLE application fee of $30 regardless of whether or not the application is approved.

I read and accept Terms & Conditions