Rental Application Form

Rental Application Guidelines

Rent:    Appl. Fee:    Move-In Date:    PM:

Applicant's Name:    Date:

Property Applying For:

Policies and Procedures

Qualified applicants should have all of the following:

• A clear credit record

• Proof of monthly income approximately 3 times the monthly rental amount

• Good personal, employment and landlord references

• Valid photo identification (driver's license, military I.D. or state I.D.)

Each adult (18 years or older) who intends to live at the property MUST complete and sign a separate application and pay an application fee. Processing will not begin until the application is complete and the fee has been paid.

We may also ask for the following information:

In some cases, we may require last year’s W-2 form and your two most recent pay stubs.

If you are self-employed or retired, we will require the last two years’ tax returns, bank statements showing monthly income, or similar documents to verify your current financial situation.

How to Apply

All pages of the application must be completely filled out, signed and dated by applicant. Documentation and correct reference names and phone numbers must be provided so that we can verify your income and references. Application processing normally takes one to three business days. Applications received without all the necessary information are considered incomplete and will not be processed until everything has been submitted. You will be notified as soon as your application has been reviewed and accepted.

What We Need From You

1. Application Fee of $20.00 for each adult (U.S.) or $25.00 for each adult (Canadian). This fee is nonrefundable.

2. Income Verification: last year's W-2 and your two most current pay stubs or last two years' tax returns.

3. After an application is accepted, we require that the SECURITY DEPOSIT, equal to one month's rent, be paid in full by CASHIER'S CHECK OR MONEY ORDER prior to renting. The Security Deposit must be paid within 24 hours of notification that your application has been approved. No properties will be held vacant for a period longer than 14 days. Please make your check payable to Clark Realty Corporation. The first month's rent (due at lease signing) must also be in the form of a CASHIER'S CHECK OR MONEY ORDER.

Applicant's Personal and Credit Information

(Complete separate application for each tenant.)

Applicant (Please print):    Social Security No.:

First:    Middle:    Last:

Driver's License No.:    State:

Present Address:    City/State/Zip:

Res. Phone:    Cell Phone:    Bus. Phone:

Fax. Phone:    Email:

Additional Occupant:    Relation:    Social Security No.:

Additional Occupant:    Relation:    Social Security No.:

Additional Occupant:    Relation:    Social Security No.:

Additional Occupant:    Relation:    Social Security No.:

How long at present address?    Landlord or Agent:    Phone:    Rent amount:

Why are you moving?    Pets?

Previous Address:    City/State/Zip:

How long at previous address?    Landlord or Agent:    Phone:    Rent amount:

Why did you move?

Car Make:    Year:    Model:    Color:    License No.:

Car Make:    Year:    Model:    Color:    License No.:

Occupation:    Prior Occupation:

Employer:    Prior Employer:

Self-employed, dba**:    Prior Self-employed, dba**:

Business Address:    Prior Business Address:

Business Phone:    Prior Business Phone:

Type of Business:    Prior Type of Business:

Position Held:    Prior Position Held:

Name/Title of Superior:    Prior Name/Title of Superior:

Hire Date:    Prior Hire Date:

Monthly Gross Income:    Prior Monthly Gross Income:

* If employed less than two years, provide information on prior occupation.

** If self-employed, you will need a copy of the last two years of income tax returns and documentation for the current year, i.e., bank statements, etc.

Bank Name:    Branch:    Savings Account No.:    Checking Acct. No.:

Name of Nearest Living Relative:    Relationship:    Address:    Telephone No.:

1. Personal Reference (Hawaii Resident):    Telephone No.:    2. Personal Reference (Hawaii Resident):    Telephone No.:

In Case of Emergency, Notify:    Relationship:    Address:    Telephone No.:

Application Questions

1. Have you ever filed a petition of bankruptcy? Yes No

2. Have you ever been evicted from any tenancy or had an eviction notice served on you? Yes No

3. Have you ever willfully and intentionally refused to pay any rent when due? Yes No

4. Have you ever been convicted of a misdemeanor or felony other than a traffic or parking violation? Yes No

5. Are you a current illegal abuser or addict of a controlled substance? Yes No

6. Have you ever been arrested for or convicted of the illegal manufacture or distribution of a controlled substance? Yes No

If you answered "yes" to any question above, please explain below:

Clark Realty Corporation reserves the right to deny rental applications or tenancy to any person convicted of a crime involving the sale of unlawful drugs, violence, threats of violence, moral turpitude or abuse of minors, and further reserves the right to confirm the accuracy of an applicant's statements with respect to criminal history.

By signing below, I acknowledge that I have read and understood this application. I authorize Clark Realty Corporation to verify all information contained in this application including credit, landlord, employment and income information. If my application is approved, I further authorize Clark Realty Corporation to answer questions regarding my resident history with future landlords.

I declare that the information I have supplied here is true and correct and I agree that the Landlord may terminate any Rental Agreement or other agreement entered into with me in reliance on false or misleading statements I have made above.

NOTE: In order to provide equal opportunity and a fair environment for all applicants who apply for properties managed by Clark Realty Corporation, please note: In the case of multiple applications that receive preliminary credit approval, the final selection will be made via the following evaluations:

Which Applicant

• has a higher credit score,

• has a better income to debt ratio or more “disposable” income,

• has better landlord references,

• is available to move in sooner,

• has pets vs. no pets and the type of breed.

The results of all of the 5 questions above will be weighed in making the determination for which applicant is ultimately accepted. The application fee is refundable only if another applicant is approved to rent the dwelling before checking your credit history. Otherwise, the fee is entirely non-refundable.

Disclaimer: Occasionally properties may not be available for occupancy on the day advertised due to unforeseen circumstances. We are not responsible for providing alternate housing if the property you want to rent is not available on the date advertised.

I have read and fully understand Clark Realty Corporation’s rental application. I hereby authorize current and previous landlords, rental agents and property managers to verify the information I have provided on the application and obtain rental references. I also authorize current and previous Employers to verify the employment information I have provided on the application.

Print Name

Big Island Property Disclosure

The following information is intended to assist the applicant/tenant with identifying some of the general conditions that may affect the use of some real properties on the Big Island. This form is not a warranty of any kind by Clark Realty Corporation, nor is it a substitute for expert inspection or professional advice or any warranties that applicant/tenant may wish to obtain. Applicant/tenant is advised to obtain public records, professional advice and to have experts inspect the property. This form is not intended to be an exhaustive list of all the conditions relating to occupancy of real property on the Big Island.

If applicant enters into a Lease Agreement this form will be attached to and made part of the Agreement.

1. Aircraft Noise and Fly Overs

Applicant/Tenant is advised that some areas on the Big Island are subject to fly overs by various aircraft, including, among others, commercial, military and DEA aircraft (Drug Enforcement Agency). Applicant/Tenant is advised to contact appropriate federal, state or county government agencies for further information on this issue.

2. Volcanoes

The Big Island of Hawaii has several active and presently inactive volcanoes. Accordingly, there are times when air quality is affected by volcanic emissions known as “vog”. Vog may affect persons with respiratory problems and may also affect water catchment systems if precautions are not taken. Applicant/Tenant should contact the State of Hawaii Department of Health or other professionals for information about recommended precautions. In addition the U.S. department of the Interior, Geological Survey, has classified various “hazard zones” for lava flows. The location of such hazard zones may affect the availability, limits and cost of personal property and/or liability insurance. Other effects of volcanic activity may occur and include lava tubes and periodic earthquakes.

3. Mold and Mildew

Applicant/Tenant is advised of the presence of mold and mildew on the Big Island. If not treated properly, molds and mildews may cause moderate to severe health problems. Preventative measures are: keep surfaces and household textiles clean and dry, keep good ventilation throughout your home, reduce sources of moisture and watch for condensation. If mildew and/or mold is found, clean and dry it, discard wet materials that cannot be dried quickly and disinfect the area. Professional mold and mildew removal companies are available to assist you when needed.

4. Unexploded Ordnance

Applicant/Tenant is advised that there may be unexploded ordnance (UXO) in the area described by the Army Corps of engineers as “roughly bounded by Kawaihae Road, Queen’s Ka’ahumanu Highway, Waikoloa Road, extending to the western boundary of the U. S. Army Pohakuloa Training Area. UXO include artillery projectiles, mortars, rockets, and grenades that were fired or thrown but failed to explode. These items can still explode if handled or disturbed. During World War II these ten empty lands were used to train American military forces for battles in the South Pacific. During the training exercises, the troops used live ammunition, and mortar rounds were fired inland. After the war, clean-up efforts were undertaken. However, recent discovery of UXO has renewed clean up activity.

5. Caribbean Tree Frog

Caribbean Tree Frogs have been expanding into various areas of the Big Island. Because tree frogs are nocturnal, the Property Manager may not hear any chirping sounds that are associated with the frogs during the daytime hours. Applicant may drive by the rental property in the evening to determine the level of frog infestation and frog chirping and whether it is acceptable to applicant. Applicant should be aware that the level of frog noise may vary depending upon such factors as weather, temperature, time of night, increase or decrease in level of infestation and other variables. In addition, the success or failure of any government eradication program may also effect the level of frog chirping.