Rental Application Form
If you are looking to rent an apartment, please fill out the form and we'll get back to you with questions and additional information.
Personal Info
First Name & Last Name *
Your answer
What is your date of birth? *
Your answer
Your Email *
Your answer
Your Phone # *
Your answer
VEHICLES *
Include vehicles belonging to other proposed occupants also
Your answer
Current Address
Your Current Address
Address, City, State/Province, Zip/Postal Code, Country
Your answer
Do you currently rent or own?
How long have you been living at your current address?
Your answer
Reason for moving?
Your answer
Employment Information
Who is your current employer?
Your answer
Employer Address
Address, City, State/Province, Zip/Postal Code, Country
Your answer
How long did you work there?
Your answer
Phone #
Your answer
Position
Job title
Your answer
REFERENCES & EMERGENCY CONTACTS
Name
Your answer
Relation
Your answer
Phone Number
Your answer
GENERAL INFORMATION
Have you ever been served a late rent notice?
Your answer
Have you ever filed for bankruptcy? If so, when?
Your answer
Have you ever been convicted of a felony?
Your answer
Have you ever been served an eviction notice? If so, when?
Your answer
Agreement & Authorization Signature
I authorize the verification of the information provided on this form. I declare that the above information, to the best of my knowledge is true and correct. I hereby authorize Proxima Property Management to obtain a consumer credit and/or investigative report on myself consisting of, but not limited to, rental and employment verification, criminal, eviction, check scan, drivers' licenses verification, and academic verification. I understand that this is an application for an apartment and does not constitute a rental or lease agreement.
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