Application

HENDRICKS ENTEPRISES RentalApplication Investors/Realtors

6742 Gulfport Boulevard, Suite 116 FOR OFFICE USE ONLY

South Pasadena, Florida33707 DATE______________________

Tel. (727) 345-1407 Fax (727) 347-2304 PROPERTY_________________

NON-REFUNDABLE APT. NO. _______RENT $_____

RENTALAPPLICATIONFEE $20.00 AGENT_____________________

Please complete all requested information on the front and back of this form. Thank you for your interest in our apartment.

Date of Application_____________________ Desired Date of Occupancy_______________________

Type and Size of Apartment Wanted (No. of Bedrooms, Etc.)__________________________________

PERSONAL INFORMATION

APPLICANT’S FULL NAME _____________________________ Date of Birth_________________

Social Security No. ___________________________ Driver’s License No./State_________________________________

CO-APPLICANT’S FULL NAME _______________________________ Date of Birth__________________

Social Security No. ___________________Driver’s License No./State _________________ Relationship___________

Full Names of All Other Residents: Relationship to You Date of Birth

_____________________________________________________________________________________

How Many Pets Do You or Other Occupants Own?____________________________________________

Kind of Pet, Breed, Weight and Age ________________________________________________________

How Did You Hear About Our Property?____________________________________________________

RESIDENCE HISTORY

PRESENT ADDRESS___________________________________________________________________

Present Telephone_____________________Dates From:____________ To:________________________

Present Landlord or Mortgage Co.___________________________Telephone___________________

Monthly Payment $________________Reason for Moving__________________________________

PREVIOUS ADDRESS__________________________________________________________________

Dates From:____________________________________________To:_________________________

Previous Landlord or Mortgage Co._________________________Telephone____________________

Monthly Payment $________________Reason for Moving___________________________________

EMPLOYMENT INFORMATION

PRESENT EMPLOYER_____________________________________Dates From:_______To:________

Employer’s Address________________________________________Telephone_________________

Position ___________________________Supervisor _____________Gross Monthly Salary $_______

PREVIOUS EMPLOYER____________________________________Dates From:_______To:_________

Employer’s Address________________________________________Telephone__________________

Position ___________________________Supervisor_____________Gross Monthly Salary $________

CO-APPLICNT’S EMPLOYER_______________________________Dates From:_______To:_________

Employer’s Address________________________________________Telephone__________________

Position ___________________________Supervisor_____________Gross Monthly Salary $________

BANKING AND CREDIT REFERENCES

BANK NAME & BRANCH__________________________________Telephone ___________________

Checking Acct. No.______________________________________Savings Acct. No._____________

Loan Acct. No._________________________________________Monthly Payment $____________

CREDIT REFERENCE______________________________________Telephone____________________

Address_______________________________________________Account No.__________________

CREDIT REFERENCE _____________________________________Telephone____________________

Address_______________________________________________Account No.__________________

OTHER REFERENCE___________________________________________________________________

Address____________________________________________________________________________

OTHER INFORMATION

TOTAL NUMBER OF VEHICLES (Includeing Company Vehicles)_____________________________________________

Make/Model____________________________Year________Color_________Tag No./State___________

Other Car, Motorcycle, etc.________________________________________________________________

Total Gross Monthly Household Income $_________________

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 $_____________Per____________Source____________________Telephone________________

Comments:_____________________________________________________________________________

______________________________________________________________________________________

HAVE YOU OR CO-APPLICANT EVER: Been sued for non-payment of rent?___Yes ___No

Been evicted or asked to move out?___Yes ___No Broken a Rental Agreement or Lease? ___Yes ___ No

Been sued for damage to rental property? ___Yes ___No Declared Bankruptcy? ___Yes ___No

In case of Personal Emergency, Notify:_________________________Relationship_________________

Address_____________________________Home Phone___________Work Phone______________

I hereby make application for an apartment and certify that this information is correct. I authorize you to contact any references that I have listed. I also authorize you to obtain my consumer credit report from your credit reporting agency, which will appear as an inquiry on my life.

APPLICANT’S SIGNATURE_____________________________________________________________

CO-APLICANT___________________________________________DATE SIGNED________________

FOR OFFICE USE ONLY – DO NOT WRITE BELOW

Date Application Received______________________________Received By________________________________

REFERENCE VERIFATION REMARKS RECORD OF PAYMENTS RECEIVED

�Present Landlord Date Descripton Amount

�Previous Landlord

�Employment

�Previous Employ.

�Co-Applicant Employ.

�Bank THIS APPLICATION: __ Approved __Not

�Credit (1) Date_______________By_________________