615B Placerville Drive, Placerville, CA 95667
Office: (530) 6AC-TION / 622-8466 Fax: (530) 622-8886
RENTAL APPLICATION for (address) _______________________________________________ NAME ___________________________ ______ ___________________________ First M.I. Last Social Security # __________ Date of Birth ________ Drivers License # __________
Home Phone _______________ Work Phone _______________ Cell Phone ________________ E-mail Address _______________________
NAME ___________________________ ______ ___________________________ First M.I. Last Social Security # __________ Date of Birth ________ Drivers License # __________
Home Phone _______________ Work Phone _______________ Cell Phone ________________ E-mail Address _______________________
PRESENT ADDRESS ________________________________________________________________ Street City State Zip Code
How long at this address? __________________ Rent $ _________ Reason for moving _____________________________________________ Owner/Manager Name____________________ Owner/Manager Phone ________________
PREVIOUS ADDRESS _______________________________________________________________ Street City State Zip Code
How long at this address? __________________ Rent $ _________ Reason for moving _____________________________________________ Owner/Manager Name____________________ Owner/Manager Phone ________________
Name and relationship of any other persons to live with you (including birthdates of children): _______________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ FINANCIAL INFORMATION: Checking Acct: Bank __________________________ Branch _________________________ Acct. # __________________ Balance in Account _____________ Savings Acct: Bank __________________________ Branch _________________________ Acct. # __________________ Balance in Account _____________ REFERENCES: Personal Reference: __________________________ Address: ________________________
Work Phone: _______________ Home Phone: _______________
Contact in Emergency: ________________________ Address: ________________________
Work Phone: _______________ Home Phone: _______________
EMPLOYMENT: Present Occupation ______________________ How long with this employer? _________
Employer ____________________________ Address ______________________________ Supervisor __________________________ Phone # ______________________________ Current Gross Income Per Month (before deductions) __________________
Previous Occupation ______________________ How long with this employer? ________
Employer ____________________________ Address ______________________________ Supervisor __________________________ Phone # ______________________________ Previous Gross Income Per Month (before deductions) __________________
Spouse's Present Occupation ________________ How long with this employer? ______
Employer ____________________________ Address ______________________________ Supervisor __________________________ Phone # ______________________________ Current Gross Income Per Month (before deductions) __________________
Previous Occupation ______________________ How long with this employer? ________
Employer ____________________________ Address ______________________________ Supervisor __________________________ Phone # ______________________________ Previous Gross Income Per Month (before deductions) __________________
List other sources of income and amount ________________________________________ ________________________________________________________________________________ OTHER GENERAL INFORMATION: Number of Vehicles ____________ Make and Model ____________________ Year ________ License # _______________ Make and Model ____________________ Year ________ License # _______________ RV and/or Boat ____________________________________________________________ If your application is approved, when would you like to move in? ______________ Length of time that you are planning to live at this address __________________ Do you or anyone living with you, smoke inside your home? _____________________ Are you looking for a month to month agreement or lease on the property? _______ Check the utilities that you will be responsible for: ____Water ____Sewer ____Garbage ____Gas ____Electric Any pets? _________ Describe the pet(s) including breed, weight, and whether they are indoor or outdoor:_____________________________________________ ________________________________________________________________________________ IF A PET IS ALLOWED, THE OWNER WILL REQUIRE A MINIMUM DEPOSIT OF $200 PER PET. Do you have a waterbed? _________ Do you have a trampoline? ________ Have you willfully and intentionally refused to pay any rent when due? _________ Have you ever filed bankruptcy? _________ Date of Bankruptcy ___________ Have you ever been evicted? ________________ If you feel there may be a problem with your credit information, please provide us with a short explanation. __________________________________________ _______________________________________________________________________________ If you have any additional questions or concerns, please discuss them with Action Properties. I declare that the foregoing is true and correct, authorize its verification and the obtaining of a credit report and public records of any unlawful activities. I authorize you or any current landlord or any previous landlord to get information and answer questions regarding my resident history and credit experience with me or any previous landlord. There are not restrictions or limitations (including written information in the tenant file) as to what information current, previous, or prospective landlords may give out. The applicant tenant holds the party giving the information free from any liability for any verbal or written information that has been provided. I agree that the application and all reports may be shared with the property owner. I agree that the landlord may terminate any agreement entered into in reliance on any misstatement made. _____________________________ ___________________ Applicant Date _____________________________ ___________________ Applicant Date
PCheck-Point
Trusted Team | Reliable Results
By signing below, I authorize the preparation of an investigative report for determination of eligibility to rent.
I authorize and understand that investigative background inquiries are to be made on myself including consumer credit, eviction, criminal, sex offense and other reports. Further, I understand that management will be requesting information from various Federal, State and other agencies, which maintain records concerning my past activities relating to my driving, credit, criminal, civil, tenancy and other experiences. I release all of the above, including Check Point and it’s agents to the full extent permitted by law from any claims, damages, losses, liabilities and expenses arising from the retrieval and reporting of information.
All reports will be kept confidential in accordance with Federal, State and local laws.
According to the Federal Fair Credit Reporting Act, I am entitled to know if I was denied based on the information obtained and to receive, upon written request to the company requesting my information, a disclosure of the public record information and of the nature and scope of the investigative report.
I, the undersigned applicant, do hereby certify that the information provided by me is true and complete to the best of my knowledge. Any copy of this document is as valid as the original. Falsifying information could result in denial of rental tenancy.
Print Full Name: ______________________________________________________________________
Soc. Sec. #:____________________________________ *Date of Birth:________________________
Current Address: _____________________________________________________________________
City/State/Zip:________________________________________________________________________
Driver’s License#_________________________________ State:_______________________________
Have you ever been convicted of a crime? No / Yes
Applicant’s Signature: ___________________________________________ Date:_______________
*Date of birth is being requested in order to obtain accurate retrieval of records.
3539 Bradshaw Rd #B307 Sacramento, CA 95827 | P 888-534-1233 916-855-5472 | f 888-332-4128 916-363-0977
PCheck-Point
Trusted Team | Reliable Results
By signing below, I authorize the preparation of an investigative report for determination of eligibility to rent.
I authorize and understand that investigative background inquiries are to be made on myself including consumer credit, eviction, criminal, sex offense and other reports. Further, I understand that management will be requesting information from various Federal, State and other agencies, which maintain records concerning my past activities relating to my driving, credit, criminal, civil, tenancy and other experiences. I release all of the above, including Check Point and it’s agents to the full extent permitted by law from any claims, damages, losses, liabilities and expenses arising from the retrieval and reporting of information.
All reports will be kept confidential in accordance with Federal, State and local laws.
According to the Federal Fair Credit Reporting Act, I am entitled to know if I was denied based on the information obtained and to receive, upon written request to the company requesting my information, a disclosure of the public record information and of the nature and scope of the investigative report.
I, the undersigned applicant, do hereby certify that the information provided by me is true and complete to the best of my knowledge. Any copy of this document is as valid as the original. Falsifying information could result in denial of rental tenancy.
Print Full Name: ______________________________________________________________________
Soc. Sec. #:____________________________________ *Date of Birth:________________________
Current Address: _____________________________________________________________________
City/State/Zip:________________________________________________________________________
Driver’s License#_________________________________ State:_______________________________
Have you ever been convicted of a crime? No / Yes
Applicant’s Signature: ___________________________________________ Date:_______________
*Date of birth is being requested in order to obtain accurate retrieval of records.
3539 Bradshaw Rd #B307 Sacramento, CA 95827 | P 888-534-1233 916-855-5472 | f 888-332-4128 916-363-0977