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PRO FESSION AL PRO PERTY M ANA GEMEN T O F NORT HERN VIRG INI A, INC. 5105-K Backlick Road Annandale, Virginia 22003 E-Mail ppm@ppmnva.com www.ppmnva.com TEL 703-642-3010 FAX 703-642-3619 (Red) FAX 703-256-4720 (Blue) 14127 Robert Paris Court Chantilly, Virginia 20151 TEL 703-639-1990 FAX 703-378-1414 (Green) RENTAL APPLICATION This Rental Application is an offer to rent. The Deed of Lease is a legally binding contract. It is unlawful to discriminate on the basis of race, color, religion, national origin, sex, elderliness, familial status or handicap. This Application will be processed in accordance with all Fair Housing and occupancy laws. The Applicant/s acknowledge by their initials that in this real estate lease transaction, ____________________________________________, the Listing Company and the Property Manager represent the Landlord and that the Leasing Company, ____________________________, represents Landlord or Tenant. (If the Brokerage Company is acting as a dual representative of both the Landlord and Tenant, then the appropriate disclosure form is attached to and made a part of this Application.) Applicant/s Initial ___________ / ___________ Leasing Agent must attach a business card. Applicant/s Identification Type and Expiration Date: and (Applicant/s) offer to lease , Virginia , (“Premises”) for year/s beginning for the monthly rent of $ payable in advance on the first day of each month. The Premises are accepted in the current condition, unless noted below or by attachment. Occupancy is subject to possession being delivered by the present occupant. A NON-REFUNDABLE PROCESSING FEE OF $ 50.00 per Applicant is included with this Application. Processing may take up to 5 business days to complete. AN EARNEST MONEY DEPOSIT OF $ (“Deposit”) is included and will be held by . If this Application is accepted, the Deposit will be credited toward funds owed to the Landlord. If this Application is not accepted the Deposit will be refunded to the Applicant/s less any additional documented processing charges. APPLICANT/S AGREE AND UNDERSTAND THAT: 1. Applicant shall execute the Lease within 3 business days after approval by the Landlord. The listing company is obligated to present all applications to the Landlord until the Lease is signed. 2. Landlord/Agent may withdraw approval and resume marketing Premises at any time until Lease is signed. 3. Applicant has no leasehold interest until the Lease is signed. 4. **Military attach copy of orders and LES. **Hourly/weekly employees attach last 2 years From W-2. **Self-employed attach copy of last 2 years of US Tax Form 1040 and Schedule C.** 5. A sample draft of the proposed Lease may be reviewed at www.ppmnva.com. 6. Any move-in fees and utility deposits are the responsibility of the Applicant 7. The Application consists of 3 pages which must be completed in full. Incomplete or missing information will result in delay of a decision. Willful misrepresentation may be grounds for invalidating a Lease. 8. The Applicant/s must obtain property and liability insurance (Renter’s Insurance) and assume utility accounts where required before occupying the Premises. Contact Numbers: Applicant 1 Cell: Home: Email: Page 1 of 3 Contact Numbers: Applicant 2 Cell: Home: Email: Please initial________ / _______ I / We understand that only those ___ persons listed in this application are to live in the Premises and that the home is not to be used for business. I /We authorize the firm processing this application to verify any of the information from this application and to perform any necessary credit or investigative reports or inquiries in order to approve the application. If any information is found to be false or misleading, the application will be rejected. Signed Date Signed Date APPLICANT 1 APPLICANT 2 Name Name Date of Birth Social Security # Date of Birth Present Street Address and House Number City State From: To: Dates of Occupancy Social Security # Present Street Address and House Number Zip City $ Rent/Mortgage Reason for Moving State From: To: Dates of Occupancy Zip $ Rent/Mortgage Reason for Moving Landlord / Mortgage Company Name Phone Previous Street Address and House Number City State From: To: Dates of Occupancy Landlord / Mortgage Company Name Phone Previous Street Address and House Number Zip City $ Rent/Mortgage Reason for Moving State From: To: Dates of Occupancy Zip $ Rent/Mortgage Reason for Moving Landlord / Mortgage Company Name Phone Landlord / Mortgage Company Name Phone CURRENT EMPLOYMENT CURRENT EMPLOYMENT Name of Company / Branch of Service Phone Name of Company / Branch of Service Phone Location Dates Location Dates Position / Rank / Rate Salary Position / Rank / Rate Salary Supervisor Name Phone Supervisor Name Phone PREVIOUS EMPLOYMENT PREVIOUS EMPLOYMENT Name of Company / Branch of Service Phone Name of Company / Branch of Service Phone Location Dates Location Dates Position / Rank / Rate Salary Position / Rank / Rate Salary Supervisor Name Phone Supervisor Name Phone OTHER INCOME OTHER INCOME $ Amount How would you rate your credit? Page 2 of 3 Source $ Amount Source How would you rate your credit? Please initial________ / _______ Please Answer 1. Have you ever filed for bankruptcy? 2. Have you ever been evicted? 3. Do you have any judgments? 4. Have you had a foreclosure? 5. Are you a party to a lawsuit? 6. Do you pay alimony or child support 7. Are you a co-signer of a note or another lease? 8. Have you ever had a rental application rejected? APPLICANT 1 Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No APPLICANT 2 Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No EXPLANATION APPLICANT 2: ASSETS / CREDIT / LOANS APPLICANT 1: ASSETS / CREDIT / LOANS Car / Card Balance Monthly $ Car / Card Balance Monthly $ OTHER OCCUPANTS OF PREMISES Last Name First Name Mid Initial Date of Birth Relationship ADDITIONAL INFORMATION: Cars, boats, trucks, trailers, vans, campers, RVs and motorcycles must have current license and jurisdictional tags. No Commercial Vehicles Permitted Vehicle Make / Model Year Color Do you own, or plan to purchase a waterbed or large aquarium? Yes License Plate No State of Registration This requires Landlord Approval and Insurance Coverage CLOSE RELATIVE OR EMERGENCY CONTACT Name Relationship Address City, Phone State Zip PET INFORMATION **Liability coverage required for dogs** Type Breed Size Age Sex / Neutered License # **ALL INFORMATION MUST BE COMPLETE IN ORDER TO PROCESS APPLICATION** This is a suggested form of the Northern Virginia Association of REALTORS®, Inc. (“NVAR”). This form has been exclusively printed for the use of REALTOR® and Non-Resident members of NVAR, who may copy or otherwise reproduce this form in identical form with the addition of their company logo. Any other use of this form by REALTOR® and non-Resident members of NVAR, or any use of this form whatsoever by non-members of NVAR is prohibited without the prior written consent of NVAR. Notwithstanding the above, no REALTOR® or Non-Resident member of NVAR, or any other person, may copy or otherwise reproduce this form for purposes of resale. Page 3 of 3 Please initial________ / _______