Blueshift Real Estate Solutions Rental Application
Application for Residential Properties
Application Information
Property: *
Enter Property Address
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Comments: *
Enter comments about this application
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General Information
First Name *
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Last Name: *
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Email: *
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SSN: *
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Phone Number: *
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Birth Date: *
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Drivers LIcense # / State *
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Total # of Occupants: *
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How did you hear about us?
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Property / Address Applying For: *
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Requested Lease Term: *
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Other Info 1:
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Other Occupants
List Names and Birth Dates of ALL additional Occupants 18 Years or Older
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List Names and Birth Dates of ALL additional Occupants 18 Years or Younger
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PETS
Pets? *
Required
If Yes Describe *
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PETS
Residence / Rental History Current Address
Street Address: *
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Monthly Rent: *
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Dates of Residency (From / To): *
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Reason For Leaving: *
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Landlord/Manager Name *
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Landlord / Manager Phone: *
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Residence / Rental History Previous Address
Street Address: *
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Monthly Rent: *
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Dates of Residency (From / To): *
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Reason For Leaving: *
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Landlord/Manager Name *
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Landlord / Manager Phone: *
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Employment / Income History
Employer Name: *
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City: *
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Emnployer Phone: *
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Dates of Employment (From / To): *
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Gross Monthly Pay: *
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Occupation: *
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Other Income Description
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References
Name 1: *
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Name 2: *
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Phone 1: *
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Phone 2: *
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Emergency Contact
Emergency Contact Name: *
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Email: *
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Phone: *
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BACKGROUND INFORMATION
Have you ever:
If You checked either of the boxes for Eviction or Criminal Record, provide Proeprty Name, City, State, and County and Landlord Name for eviction, and for Criminal provide type of Offense, County and State
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VEHICLE INFORMATION
1. Make & Model
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Year
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License and State
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2. Make & Model
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Year
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License and State
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Other Vehicles:
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BACKGROUND INFORMATION
Cosigner / Guarantor
Cosigner / Guarantor Name:
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SSN:
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Address:
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Email:
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Phone:
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Comments:
Applicant Comments:
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Application Agreement
Agreement: *
Blueshift Real Estate Solutions Charges a non-refundable $50 application fee. I have read, agree and affirm that all of my statements and information provided in this application are true and complete. I acknowledge that false, undisclosed, incomplete or misleading information herein may constitute grounds for rejection of this application, termination of right of occupancy of all residents and occupants under a lease and/or forfeiture of deposits and fees, and may constitute a criminal offense under the laws of this state. I understand that this application is preliminary only and does not bind you to execute a Lease or to deliver possession of the premises to me. I authorize you to contact any references listed above and to obtain consumer reports, which may include credit, rental payment and/or eviction history and criminal background information about me and in order to verify the above information. I understand that as my prospective landlord, any co-applicants, occupants, or guarantors that may be added to this application may need to consent to and successfully pass consumer background screening reports. By agreeing, I authorize you to obtain subsequent consumer reports, including credit reports, to ensure that I continue to satisfy the terms of my tenancy, for the collection and recovery of any financial obligations relating to my tenancy, or for any other permissible purpose. Further, if I have included information on co-applicants, other adult household members, and/or guarantors on this application, I affirm that those individuals have knowledge of their inclusion on this application and expressly authorize you to obtain subsequent consumer reports, including credit reports. I understand that you may report all positive and negative rental payment history to consumer reporting agencies who track this information for landlords, mortgage companies and other creditors. I and all occupants or guarantors hereby release from all liability or responsibility all persons and corporations requesting or supplying such information.
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This form was created inside of Blueshift Real Estate Solutions.