Application to rent apartment ___________ Date________
Name:______________________________________
Current Address:
Street: ______________________________________________________ Apt #: ____
City: ______________________________________ State: ___________ Zip: _______
Phone: Day: _________________ Eve: __________________ Cell: ________________
Email Address: ______________________ Website: ____________________________
Current Landlord: _______________________________________________________
Street: _____________________________________________________ Suite #: ____
City: ______________________________________ State: ___________ Zip: _______
Phone: Day: _________________ Eve: __________________ Cell: ________________
Email Address: ______________________ Website: ____________________________
Previous Address:
Street: ______________________________________________________ Apt #: ____
City: ______________________________________ State: ___________ Zip: _______
Previous Landlord: ____________________________________________________
Street: _____________________________________________________ Suite #: ____
City: ______________________________________ State: ___________ Zip: _______
Phone: Day: _________________ Eve: __________________ Cell: ________________
Email Address: ______________________ Website: _____________________________
Current Employer: ________________________Current job:_____________________
Name of Company Contact: ________________________ Title: _________________
Street: _____________________________________________________ Suite #: ____
City: ______________________________________ State: ___________ Zip: _______
Phone: _________________ Fax: _______________ Email Address: _______________
Website: _____________________________
Previous Employer: ___________________ Previous job: _____________________
Name of Company Contact: _____________________Title: _____________________
Street: _____________________________________________________ Suite #: ____
City: ______________________________________ State: ___________ Zip: _______
Phone: _________________ Fax: _______________ Email Address: _______________
Website: _____________________________
References (2 Personal reference who knows you well)
name:_____________________________________ Phone: __________________
email:_____________________________________
name:_____________________________________ Phone: __________________
email:_____________________________________
Credit References
Name of Bank: ________________________
Name of Bank representative_________________________ Phone:________________
I hereby certify that I am over 18 years of age and that the above application is true.
I also give the landlord or its agents permission check my credit and contact the above mentioned references for the purpose of applying for the aforementioned apartment.
_________________________________
(Applicant’s Signature and date)
Sign and send this application to Andy Gustafson, 3126 Chicago St Omaha (or email to andygustafso@yahoo.com) Thank you.