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RENTAL APPLICATION
(Suggested questions to ask every applicant age 18 or older)

Print and mail to

PO Box 281
Gonzalez FL 32560

Or Fax to 850-968-1916

Today's Date: _________________________ Occupancy Date Desired: _____________________        

Rental Address Shown: _______________________________________________________________

APPLICANT'S PERSONAL INFORMATION
Last Name:______________________ First:_______________________ Middle:________________      

Birthdate:__________________  Driver's License/ID Number/State: ___________________________            

Social Security #:_______________________Email address: _________________________________

Cell 1_____________________ Cell 2______________________ Cell 3_______________________

Home_________________ Work_________________ Emergency____________________

Additional Occupants (List every occupant name and their relationship below, including children)

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Are you able to handle all the minor maintenance/upkeep in the property
Yes ___ No___. Check the following items that you own -
Vacuum Cleaner ___ Mop ___ Broom ___ Plunger ___ Lawn Mower ___
Appliances (if so, which ones) ____________________________________
Please note: Residents who handle minor maintenance and repairs on the property and pass property inspections are eligible to receive credit to help purchase a future home (that's part of our future homeowners program).
Check all professional level skills possessed:  Electrical ____ Painting ____ Plumbing ____

Roofing ____ Appliance repair ____ Air Conditioning ____  Heating ____ Carpentry ____

Do you have renter's insurance? _____________ Do you have any water-filled furniture? _____________
Have you ever broken a lease? _________ Have you ever refused to pay rent for any reason? __________
Have you ever been evicted or asked to leave a rental unit? _______ Ever filed for bankruptcy? _________
Ever been convicted of a crime ____ Will you give us permission to do a criminal background check? _____
Currently have any utilities in your name? ______    Currently have phone service in your name? _______

Is there anything to prevent you from placing utilities or phone in your name? _____________________
Do you know of anything or any reason which may interrupt your ability to pay rent? ______________

RESIDENCE HISTORY
Present Street Address ______________________________________________________________
City _________________________________ State _______________ Zip ____________________ 

Dates lived at this address?_____________________________ Own ____ Rent ____ Occupy _____

Current Phone _______________________  How many pets did you have? _____ Type___________
Name of present landlord/owner/mortgage company: ________________________________________
Address of present landlord/mortgage company: ___________________________________________
Landlord's phone: ____________________________ Monthly payment: _______________________
Reason for moving:____________________________ Is your rent/mtg current? __________________
Number of late payments? __________ Security Deposit Amount currently held by landlord? _______

Previous Residence Address: __________________________________________________________
Previous landlord:_________________________ Previous landlord's phone:_____________________

Dates at this address:_______________________Reason for moving?___________________________
Was your Full Security Dep. Returned?______ # of late payments? ____ Monthly payment? ________

Previous Residence Address: __________________________________________________________

Previous landlord:_________________________ Previous landlord's phone:_____________________

Dates at this address:_______________________Reason for moving?___________________________
Was your Full Security Dep. Returned?______ # of late payments? ____ Monthly payment? ________
                                                                                                                                               

INCOME HISTORY                                                                                                                              

Applicant's current employment status:                                                                                                

Full-time _____ Part-time (less than 32hrs) _____ Student _____ Retired _____ Self-employed _____
Unemployed ______ Other _________________________________________________________

Primary source of employment:
Applicant employed by: ______________________ Supervisor's name:______________________
Average Weekly hours:_______________ How long at they place of employment? ______________
Address:_______________________________________________________________________
City:__________________________________________ State: ________ Zip: _______________            

Phone: ________________ Position:________________________ Salary: ___________________
Please indicate Weekly, Bi-Weekly, Monthly, or Annual Average Take home:___________________

Additional Employment
Employed by:_____________________________ Supervisor's name:________________________
Average Weekly hours:_______________ How long at they place of employment? ______________
Address:_______________________________________________________________________
City:__________________________________________ State: ________ Zip: _______________             

Phone: ________________ Position:________________________ Salary: ___________________
Please indicate Weekly, Bi-Weekly, Monthly, or Annual Average Take home:___________________



PERSONAL/PROFESSIONAL REFERENCES
Character/Personal reference:
Name____________________________________________________________________________
Relationship?________________________ Phone __________________

Name of Nearest Living Relative:
Name____________________________________________________________________________
Relationship?________________________ Phone _________________

Applicant acknowledges this application will become part of the lease agreement when approved. If any information is found to be incorrect, the application will be rejected and any subsequent rental agreement becomes void. False and misleading statements will be sufficient reason for immediate eviction and loss of security deposit. By signing, you agree to permit landlord to do a background check, rental history, credit check and understand that the landlord will report good and bad payment history to the national credit bureaus.