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2.0 Rental Form
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* Indicates required question
Name
*
Your answer
Phone
*
Your answer
Number of bedrooms needed (click all that apply)
*
efficiency
1 Bd
2 Bd
3 Bd
4 Bd
5 Bd
6 Bd
Other:
Required
Source of Income (click all that apply)
*
Job
SSI or SSD
Section 8
Food Stamps
CAP Program
Other Assistance
Other:
Required
If you said YES to Job ... Where do you work? How Long? (example..........Lowes - 6 months) If you said NO to a job write NO. (Do this for anyone that will be living in the home.)
*
Your answer
Monthly Income Total of all Sources
*
under $500
$500-$1000
$1000-$1500
$1500-$2000
$2000-$2500
$2500-$3000
$3000-$4000
over $4000
Other:
When do you need to move by
*
immediately
within a week
within 2 weeks
within a month
within the next couple months
Other:
List any pets
*
No pets
1 cat
1 dog
2 or more cats
2 or more dogs
Fish
Other:
Required
If you have a dog(s) ... Please list type ... if no dog put NO
*
Your answer
Current Landlord Name and Phone number ... If no Landlord put NO
*
Your answer
Job Supervisor and phone number ...
if no supervisor put NO
*
Your answer
Reference Name and phone number ...
If no reference put NO
*
Your answer
List Names and birthdates of everyone that will live at the home. Example (John Smith - 4.23.77)
*
Your answer
List any Rental Addresses you are interested in
Your answer
Anything else you would like to tell me?
Your answer
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