RENTAL APPLICATION FOR 4724/26 LYNDALE AVE S

Name:

Current address:

City/Zip

Phone #:

Email:

Cell:

Date of Birth:

How long at current address?:

Landlord name:

Landlord phone:

Occupation/ current job:

How long have you been there ??

Work reference (preferably supervisor) phone and/or email:

Professional reference: Phone #/email:

Professional reference: Phone# / email:

Driver Lic #:

Car make:

Car license #:

Family/emergency Phone #:

Family/ emergency / phone # :

DO YOU SMOKE - even just a few a day ,, or socially?

Have you ever been evicted?

Have you ever filed for bankruptcy?

Do you have a police record?

ANY DRUG USE? HEALTH CONCERNS?

return to duplex@artguat.org

Signed>>>>>>>>