If you have any questions, Click the icon to the right to Chat with a Live Operator NOW!!!

 

On-Line Application Form

Select the items that apply, and then let us know how to contact you.

Process Application for Lease
Send company literature
Have a Rental Agent contact me

Pay your application fee by clicking on the "Pay Application Fee" button to the left or by clicking the link at the bottom of the page.

Click the PayPal "Add to Cart" icon to submit payment for processing this application at PayPal.  There is a $35.00 non-refundable fee for processing an Application for Lease ON-LINE with PayPal.  You have the convenience to do this on-line, but the Payment must be processed prior to the application being processed.  You will receive a Pay Pal .  You have the convenience to do this on-line, but the Payment must be processed prior to the application being processed.  You will receive a Pay Pal confirmation number.  Come back to this application.  Enter the paypal authorization code and then submit the application.

 

 

Pay Application Fee  l.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!">

Enter the PayPal Authorization and continue.  Thanks.

Payment Date/Time
Paypal AuthorizationPayment Date/Time
Paypal Authorization Code:

 

Application Type (Select One):BOX" name="ApplicationForOwnerFinancing" value="ON"> Application for Financing
    Application for Lease to Own

Date/Time

 

 Please identify the rental property address that you are making application for:

larryrtaylor.com

Property

Address:

Applicant's Information:
First Name:
Middle Initial:
Last Name:
Maiden Name:
Social Security Number:
Date of Birth:
Drivers License Number:
State that issued Drivers License:
Address
E-mail
Home Phone:
Pager: 
Cellular Phone:

 

Applicant Spouse's Information:
First Name:
Middle Initial:
Last Name:
Maiden Name:
Social Security Number:
Date of Birth:
Drivers License Number:
State that issued Drivers License:
Address
E-mail:
Home Phone:
Pager: 
Cellular Phone:

 

    Please list the Names, Ages and Relationships of all other persons to occupy these premises.   

Name: 

Age:

Relationship to Applicant:
Occupant #1
Occupant #2
Occupant #3
Occupant #4

 

Have you or any other occupant(s) ever been evicted?              Yes   No  

Explanation for eviction:

Have you or any other occupant(s) ever been charged with a crime?  (other than minor traffic tickets)                                                                                               Yes   No  

Explanation for criminal charges:

Have you or any other occupant(s) ever been involved in a lawsuit?            Yes   No

Explanation for lawsuit:

 Have you or your spouse ever filed bankruptcy?                         Yes   No  

Explanation for bankruptcy:

Have you or your spouse ever had credit problems?              Yes   No  

Explanation for credit problems:

 

 Applicant's Current Residence: 

Applicant's Current Leased/Owned Address:
Landlord or Mortgage Company:
Agent's Name:
Landlord's Address
Landlord's E-mail:
Landlord's Office Phone:
Landlord's Pager: 
Landlord's Cellular Phone:
Monthly Rental Payment:
Length of Lease:
Start of Lease Date:
Expiration of Lease Date:
Amount of Notice Required:

Is your current lease in good standing?                                Yes   No 

Explanation for lease standing:

Is rental payment current and up-to-date?                           Yes   No 

Explanation for Rental Payment not being current:

Have you or your spouse ever been late in paying?              Yes   No 

Explanation for paying late:

 Have you or your spouse ever any conflict or disagreements with your Landlord?              Yes   No 

Explanation for conflict(s) with Landlord:

 What are some of the Reason(s) why you want to move?

Explanation for moving:

 

 Please provide previous residential information for the last 7 years:

Address with zip:

Dates:

Landlord or Mortgage Company (include phone number):
Address #1
Address #2
Address #3
Address #4
Address #5
Address #6

 

Applicant's Income Information: 

                   Current Employer - (pay stubs will be required)

Applicant's Current Job Title (or description):
Employer's Name:
Manager or Supervisor's Name:
Employer's Mailing Address
Employer's E-mail:
Employer's Office Phone:
Employer's Pager:
Employer's Cellular Phone:
Monthly Income:
Amount of Pay each payday:
Length of Employment:
Start of Employment Date:

Other income amount:  (include child support only if needed to show sufficient income)  

Applicant's Additional Income Source (provide description):
Additional Employer's Name:
Manager or Supervisor's Name:
Additional Employer's Office Number:

Do you or your spouse receive Housing Assistance?*              Yes   No 

Housing Assistance Information (provide description):
Program's Name:
Case Number:
Person receiving Assistance:
Case Manager's Name:
Case Manager's Office Number:
Amount of Assistance Approved:

*Application approval is subject to the Landlord's acceptance of the Housing Assistance Program Rules and Terms; and an acceptable rental amount / assistance agreed to by the Housing Assistance Program.  Copy of any Housing Assistance Vouchers will be required at time of application completion.

Credit references:

 Do you or your spouse pay Child Support?                               Yes   No 

Amount of Child Support:

 What are some of your other monthly bills?

Car Payments:
Other Payments:

 Additional Creditor Information:

Creditor Name:

Account Number:

Creditor Address & Phone:

Amount Owed:

Creditor #1
Creditor #2
Creditor #3
 List two (2) Personal references (non-family members and different from emergency contacts):

        Personal Reference #1

 Name:
Address:
Telephone Number:
Relationship:
Length of Time Known:

         Personal Reference #2

  Name:
Address:
Telephone Number:
Relationship:
Length of Time Known:

 

Vehicle(s) kept at residence:     

Make:

Model:

Year:

License Number:
Automobile #1
Automobile #2
Automobile #3

 

 Do you know what the monthly rent and security deposit is?             Yes   No 

Monthly Rental Amount:

Security Deposit:

  Will you be able to pay the first month's rent and 
  security deposit before moving in?                                                    Yes   No 

  You will be required to transfer or establish all services 
and utilities into your name prior to receiving the keys 
to move in.  This may require additional deposits from you.
Are you able to establish these accounts in your name at
least two days before moving in?                                                     Yes   No 

Length of Lease desired:

Date you wish to move in:

 

Do you own any pets?                                                                           Yes   No 

Description of Pet(s) 
(i.e. type of animal, breed, weight, housebroken, do they bite?):

(pets may not be permitted at this location – if pet is permitted a non-refundable pet deposit will be required and you may be required to obtain liability insurance.)

Do you own a waterbed?                                                                    Yes   No 

Do you have waterbed insurance?                                                      Yes   No 

If yes, please provide evidence of insurance.  

 Personal Banking Information:

Bank Name:
Address:
Telephone Number:
Checking Account Number:
Savings Account Number:
Length Account has been Open:

 

Emergency contacts: (provide two contacts)

        Emergency Contact #1

  Name:
Address:
Telephone Number:
Place of Employment:
Work Number:
Cellular Number:
Relationship:
Length of Time Known:

         Emergency Contact #2

  Name:
Address:
Telephone Number:
Place of Employment:
Work Number:
Cellular Number:
Relationship:
Length of Time Known:

   

Credit, Criminal, Financial, & Personal Information Authorization

Applicant's Name:
Social Security Number:
Date of Birth:
Address

 

I hereby authorize this prospective landlord to obtain copies of my credit profile in accordance with the Fair Credit Reporting Act to help determine my qualification as a tenant.  The above information is provided to assist in obtaining my credit profile and I have affixed my legal signature at the bottom of this authorization as descried and mandated by the provisions of the Fair Credit Reporting Act.  I further authorize the release of my employment information, rental history, financial information, services information, utility information, public record, arrest record ( if any) and personal information as necessary to validate, verify, and confirm information provided in conjunction with the application for lease, renewal of lease, or collection activities.

 

The undersigned applicant attests that all of the above information is true and accurate.  I understand that if I am accepted as a tenant, this application will become part of the lease.  False information may be cause for decline of my application, eviction and revocation of lease agreement by landlord.  I hereby authorize verification of all information, references and credit records and to make whatever inquiries deemed proper and necessary regarding my qualifications as a tenant.  I also authorize my employer, landlord, service provider(s), utility provider(s), previous employer(s), previous landlord(s), creditor(s), city, state and federal government agencies or their respective agent(s) to furnish the landlord, owner, such information as requested by them.

A non-refundable fee of $30.00 is charged on all rental applicants ($30.00 for addition of spouse or other adult applicant) for the purpose of verifying the information included in this application. Keys will be furnished only after a lease and other rental documents have been executed by all parties, security deposits have been paid, additional amounts required have been paid and one (1) month lease payment made.  (Personal check(s) accepted as security deposit and first month’s rental fee must clear applicant’s bank to fulfill lease agreement and prior to issuance of keys.  If personal check accepted as payment of security deposit or first month’s rental fee is returned for any reason by applicant’s bank the lease agreement may be revoked by landlord at landlord’s discretion; and in such case landlord may terminate lease agreement, keep fee(s) paid and proceed with collection activities to collect amount(s) written on unpaid check(s).)

 

This application is preliminary only and does not obligate the Landlord or his agent to execute a lease or deliver possession of the proposed premises.  I further understand that upon being accepted as a tenant I will have no more than 5 days in order to execute a lease agreement.  I HAVE READ, AGREE TO, AND UNDERSTAND THIS AGREEMENT.

 

Date:Applicant Signature:

 

Please return completed application to interviewer along with $30, copy of last 2 months of bank statements, copy of last 2 months of employment pay stubs and copy of current driver’s license.


Credit, Criminal, Financial, & Personal Information Authorization

Applicant's Name (spouse):
Social Security Number:
Date of Birth:
Address

 

I hereby authorize this prospective landlord to obtain copies of my credit profile in accordance with the Fair Credit Reporting Act to help determine my qualification as a tenant.  The above information is provided to assist in obtaining my credit profile and I have affixed my legal signature at the bottom of this authorization as descried and mandated by the provisions of the Fair Credit Reporting Act.  I further authorize the release of my employment information, rental history, financial information, services information, utility information, public record, arrest record ( if any) and personal information as necessary to validate, verify, and confirm information provided in conjunction with the application for lease, renewal of lease, or collection activities.

 

The undersigned applicant attests that all of the above information is true and accurate.  I understand that if I am accepted as a tenant, this application will become part of the lease.  False information may be cause for decline of my application, eviction and revocation of lease agreement by landlord.  I hereby authorize verification of all information, references and credit records and to make whatever inquiries deemed proper and necessary regarding my qualifications as a tenant.  I also authorize my employer, landlord, service provider(s), utility provider(s), previous employer(s), previous landlord(s), creditor(s), city, state and federal government agencies or their respective agent(s) to furnish the landlord, owner, such information as requested by them.

 

A non-refundable fee of $30.00 is charged on all rental applicants ($30.00 for addition of spouse or other adult applicant) for the purpose of verifying the information included in this application. Keys will be furnished only after a lease and other rental documents have been executed by all parties, security deposits have been paid, additional amounts required have been paid and one (1) month lease payment made.  (Personal check(s) accepted as security deposit and first month’s rental fee must clear applicant’s bank to fulfill lease agreement and prior to issuance of keys.  If personal check accepted as payment of security deposit or first month’s rental fee is returned for any reason by applicant’s bank the lease agreement may be revoked by landlord at landlord’s discretion; and in such case landlord may terminate lease agreement, keep fee(s) paid and proceed with collection activities to collect amount(s) written on unpaid check(s).)

 

This application is preliminary only and does not obligate the Landlord or his agent to execute a lease or deliver possession of the proposed premises.  I further understand that upon being accepted as a tenant I will have no more than 5 days in order to execute a lease agreement.  I HAVE READ, AGREE TO, AND UNDERSTAND THIS AGREEMENT.

 

Date:Applicant (spouse) Signature:

 

Please return completed application to interviewer along with $30, copy of last 2 months of bank statements, copy of last 2 months of employment pay stubs and copy of current driver’s license.

 

Back to...  Pay Application Fee, Property For Sale, Property For Rent, Sell Your Property, Lease Your Property, Advertise Your Property Here or Home.