Home and Auto Lease Application

HOME AND AUTO LEASE APPLICATION

Property Identification

Applicant Information

Applicant Name:    Date of Birth:

Driver's License / ID #:    State of Issue:

Lease and Financial Terms (Proposed)

Desired Lease Start:    Lease End:

Security Deposit Offered:    Application Fee Paid:

Proposed Payment Due Day Each Month:    Late Fee (if any) / Grace Period:

Employment, Income and References

Position:    Monthly Gross Income:    Supervisor Phone:

Vehicle and Parking Information (Auto)

Vehicle Make:    Model:    Year:

Color:    License Plate:    Parking Space / Garage #:

Policy Number:    Policy Expiration:

Occupancy, Pets and Utilities

Pets: Yes    No

Disclosures and Condition

Lead-Based Paint Disclosure: Yes    No

Known Mold or Water Intrusion: Yes    No

Prior Structural or Fire Damage Repaired: Yes    No

Background, Credit and Authorization

Applicant understands and authorizes verification of credit, criminal history, rental history and employment. Applicant acknowledges that false statements or omissions are grounds for denial of this application or termination of any lease entered pursuant to this application.

Applicant authorizes Owner/Agent to obtain consumer reports and to contact employers, landlords, and references. Applicant releases such parties from liability for information provided in good faith.

Consent to Background Check: I consent

Insurance and Indemnity

Applicant is required to maintain renter's insurance naming Owner as an additional interest and maintain automobile liability insurance for vehicles parked on premises as required by the Lease. Applicant shall provide proof of insurance prior to occupancy and upon request.

Default, Remedies and Governing Law

Applicant acknowledges that submission of this application does not constitute a lease. If a lease is entered, breach of the lease will entitle Owner to the remedies described in the lease and applicable law, including termination, damages and costs. The lease shall be governed by the laws of the state where the Property is located.

Certification

By signing below, Applicant certifies under penalty of perjury that all statements on this application are true and complete. Applicant agrees Owner/Agent may rely on this application and all information is material to Owner's decision to lease. Applicant agrees to notify Owner promptly of any material change in circumstances prior to occupancy.

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