Online Rental Application

General Application

Applicant: Last Name:
First Name:
Middle Name:
Age:
Home Phone:
Cell Phone:
Work Phone:
Total Monthly Income: $   Job   Unemployment   Retirement/SSI/SSDI   Other
If Other, Please Specify:
  Date Of Birth:
SSN:
Driver's Lic. No. & State:

Co-Applicant: Last Name:
First Name:
Middle Name:
Age:
Home Phone:
Cell Phone:
Work Phone:
Total Monthly Income: $   Job   Unemployment   Retirement/SSI/SSDI   Other
If Other, Please Specify:
  Date Of Birth:
SSN:
Driver's Lic. No. & State:

Pets: Do You Own A Pet?:
Yes       No
How Many?:
What Kind(s)?:

Occupants: List name, age, relationship of ALL persons to be occupying the premises:
Occupant 1:  Name:
Age:
Relationship:
Occupant 2:  Name:
Age:
Relationship:
Occupant 3:  Name:
Age:
Relationship:
Occupant 4:  Name:
Age:
Relationship:

Vehicles: List all vehicles to be parked on the premises:
Vehicle 1:  Type:
Year:
Make:
  Running:
Yes       No
State:
Plate:
Vehicle 2:  Type:
Year:
Make:
  Running:
Yes       No
State:
Plate:

Emergency Contact: In case of Emergency, Notify:
Emergency Contact 1:  Name:
Relationship:
  Address:
Phone:
Emergency Contact 2:  Name:
Relationship:
  Address:
Phone:

Have you ever filed for bankruptcy? :
Yes       No
Have you ever been evicted?:
Yes       No
Have you ever been convicted of a crime
other than motor vehicle violations?:
Yes       No
If YES to any of the above, please explain:

Current: Address:
City:
State:
Zip:
Year/Month Moved In:
Own Or Rent:
Are Utilities In Your Name?:
Yes       No
Reason For Leaving:
  Name of Agent/Landlord:
Phone:
Current Monthly Rent/Payment:
$

Previous
Address:
Address:
City:
State:
Zip:
Year/Month Moved In:
Own Or Rent:
Were Utilities In Your Name?:
Yes       No
Reason For Leaving:
  Name of Agent/Landlord:
Phone:
Previous Monthly Payment:
$

Applicants Current Employer: Current Or Most Recent Employer:
Address:
Phone:
Date Employed From:
Date Employed To:
Position:
Supervisor:
Phone:

Co-Applicants Current Employer: Current Or Most Recent Employer:
Address:
Phone:
Date Employed From:
Date Employed To:
Position:
Supervisor:
Phone:

Email: Applicant Email:
Co-Applicant Email:

Are all occupants able to speak English?:
Yes       No
If no, please give occupants name and what language they speak:

Personal References: Name:
Address:
Phone:
I know this person from:
  Name:
Address:
Phone:
I know this person from:

By submitting this application, I fully understand and give Cornerstone Realty my permission to; verify my/our household income, contact my/our current and previous Landlords, call my/our employer(s) to verify household income and contact references listed above. I/we further acknowledge that I/we may either provide a current police report, or one will be obtained by Cornerstone Realty for ALL adults (over the age of 18) in the household. I/we further acknowledge that this information will be used to verify my/our past rental history and current ability to pay rent, utilities and other associated costs. I also understand that a credit report will be obtained for all household members over the age of 18. Owner or Agent has the right to reject this application per the attached Credit Qualifying Criteria. Application will be used to verify good standing with creditors, banks and other debtors.