Rental Application (Each person fill out one.)

Note that there are two pages.

Address of Property This Application is for:

Return application to: Jacobson Management, PO Box 6430, Los Osos, CA 93412. Ph: 805-528-5908. Fax:805-528-6848

Name

Social Security #

Driver's License #

Present Address

City/State/Zip

Your Phone Number at Home:

Work:

Name of Owner or Manager:

Owner or Manager's Phone:

When did you move in? _________ Rent paid now $________ Have you given notice? ( ) yes ( ) no

May we call your landlord/manager? ( ) yes ( ) no Do you pay your rent on time? ( ) yes ( ) no

Have you been asked to leave? ( ) yes ( ) no Why are you moving?

Previous Address (if at above address less than 5 years)

City/State/Zip

Name of Owner or Manager

Owner or Manager's Phone

When did you move in? _________ Rent you paid $________ Did you give notice? ( ) yes ( ) no

Did you pay your rent on time? ( ) yes ( ) no Were you asked to leave? ( ) yes ( ) no

When and why did you move out?

Next Previous Address (if at above 2 addresses less than 5 years)

City/State/Zip

Name of Owner or Manager

Owner or Manager's Phone

When did you move in? _________ Rent you paid $________ Did you give notice? ( ) yes ( ) no

Did you pay your rent on time? ( ) yes ( ) no Were you asked to leave? ( ) yes ( ) no

When and why did you move out?

Names of other persons to live with you in this property

Type of car & license Number

Pet Name

Type/Breed

Weight/Size

Indoor/Outdoor

Employer's Name & Location

Employer's Phone

Date Hired

Type of work

Name of person to contact for reference

Salary per month $

Other income: $

Other income: $

Source:

Source:

Previous Employer(if worked for above employer less than 2 years)

How long employed?

Previous type of work

Employer's Phone

Name of person to contact for reference

Personal References

Name

Address

City/State/Zip

Phone

Name

Address

City/State/Zip

Phone

Please answer these questions and sign here
  • Do you have the total move-in amount available now (first month's rent & deposit)? ( ) yes ( ) no
  • Have you ever been evicted from any tenancy? ( ) yes ( ) no
  • Have you every willfully and intentionally refused to pay rent when due? ( ) yes ( ) no
  • Have you ever filed bankruptcy? ( ) yes ( ) no If yes, when?
  • Have you ever been convicted of a felony? ( ) yes ( ) no
  • Do you know of anything which may interrupt income or ability to pay? ( ) yes ( ) no

I hereby certify that the information I have given in this application to rent is true and correct to the best of my knowledge and I agree that if any such information is not as represented the Owner may disqualify me as a tenant, at the Owner's sole discretion.

I authorize the owner or his agents to verify the above information and agree that in order to do this the Owner may inquire of any source of information which the Owner deems necessary or appropriate, and that this may include but not be limited to making direct contact with the Applicant's employer, past employers, landlord, prior landlords, and obtaining a credit report.

 

Applicant Signature
Date
Names & ages of any children