the JG Real Estate Residential Rental Application

RENTAL APPLICATION
Neatly complete all information below. All applicants over the age of 18 must complete and sign their own application.
Application Fee: $45
Date of Application: __________________________________________
Which Unit Are You Applying For?_______________________________
Range of Move-n Dates: Earliest ____________ Latest ______________
Length of Lease _______________________________________ months
Rent ________/month
Name of Agent You’ve Been Working With: ________________________
Personal Information:
Applicant’s Full Name _________________________ DOB ____________ Social Security # ______________
Email ______________________________________ Phone _______________________________________
How many people are in your family? _____________ Adults ____________ Children
Name/relationships of individuals occupying the unit ______________________________________________
________________________________________________________________________________________
Do you have any pets? _______ Yes ______ No
If yes, please provide information below:
Pet’s Name ______________________________ Breed ____________________ Color _________________
Age ___________ Gender __________ Weight ____________ Spayed/Neutered? ______________________
Pet’s Name ______________________________ Breed ____________________ Color _________________
Age ___________ Gender __________ Weight ____________ Spayed/Neutered? ______________________
Prior Rental Information:
Current Address __________________________ City ______________________State ____ Zip __________
Current Landord’s Name ________________________________________ Phone # ____________________
How long at this address? _________________ Total monthly rent ___________ Utilities Included _________
Total monthly rent you were individually responsible for ____________________________________________
Reason for leaving ________________________________________________________________________
Previous Address _________________________ City ______________________State ____ Zip __________
Previous Landord’s Name _______________________________________ Phone # ____________________
How long at this address? _________________ Total monthly rent ___________ Utilities Included _________
Total monthly rent you were individually responsible for ____________________________________________
Reason for leaving ________________________________________________________________________
Have you ever been party to an eviction? _______ Yes _______ No
Current Employment Information:
Present Employer _________________________________________Position _________________________
Income ________________________ How long at this position? ____________________________________
Employer’s Address _______________________________________________________________________
Contact Person to Verify Employment _______________________ Phone #/Email ______________________
Other income/source (if applicable) ___________________________________________________________
Employer’s address _______________________________________________________________________
Contact Person to Verify Employment _______________________ Phone #/Email ______________________
Criminal History:
I do not have a criminal history _____ No person that will live in the rental has a criminal history ________
I have been convicted of a felony _____ Yes _____ No
If yes, what was the felony charge? __________________________ Conviction date ____________________
Have any members of your family living in the rental unit been convicted of a felony? ______ Yes ________
No
If yes, what was the felony charge? __________________________ Conviction date ____________________
Are you a convicted sex offender? _________ Yes _________ No
Is any member of your family who will be living in the unit a convicted sex offender? _______ Yes _______ No
Personal References:
Name ____________________ Yrs. Known ______ Relationship _____________Phone # _______________
Name ____________________ Yrs. Known ______ Relationship _____________Phone # _______________
Name ____________________ Yrs. Known ______ Relationship _____________Phone # _______________
Expectation of Unit Condition
(Note: This is not a guarantee that items listed will be done. Approval from Landlord will be required.)
Please include any items that you request to be done prior to your move-in: ____________________________
________________________________________________________________________________________
________________________________________________________________________________________
Application Disclaimer
The application fee is NON-REFUNDABLE and will not be applied towards rent or other financial
obligations should Applicant be approved, nor refunded if not approved. Applicant agrees that this
sum is paid in consideration of Landlord/Broker for Landlord's review and/or verification of the
information stated in the application.
Upon submission of this Application, Landlord/Broker for Landlord reserves the right to remove
property from the available rent list. If this application is denied by Landlord, the one month’s rent
Application Deposit shall be refunded to Applicant. If this Application is approved and Applicant fails
to rent the Property, Landlord shall be entitled to retain the one month’s rent Application Deposit.
All turnover/maintenance work is at the discretion of JG Real Estate and/or owner of the property. If
there are any specific requests, it the applicant’s responsibility to make sure they are fully disclosed to
JG Real Estate prior to lease signing in order for it to be considered.
AUTHORIZATION FOR BACKGROUND CHECK
I hereby authorize JG Real Estate, LLC. to obtain and/or verify my credit report, criminal history,
employment references and personal references in connection with the processing of this rental
application. I also agree to the above deposit and turnover/maintenance Disclaimer.
__________________________________________________________
SIGNATURE OF APPLICANT
___________________________
DATE
PLEASE SUBMIT A COPY OF THE FOLLOWING WITH THIS APPLICATION:
_______ Copy of Valid Driver’s License (or government-issued photo ID)
_______ Pay Stub (If you are not employed, provide proof of your income)
_______ W-9 Form (this is required by the back when opening an escrow account)
_______ Copy of Signed Consumer Notice (can be found on same webpage as this application)
_______ $45 Application fee made payable to “JG Real Estate, LLC”
(Can be paid via PayPal.com, money order, personal check or certified back/cashier’s check)