Rental Application Please enable JavaScript in your browser to complete this form.Applicant DetailsYour Full Name (First Middle Last) *Telephone Number *Your Current Address *State ID or Drivers License # *State of Issue *Date of Birth *SSN *Your Email (required) *How long at current address? *Why are you moving? *Current Landlord Name *Current Landlord Phone *Ever been Convicted of a Misdemeanor or Felony? *NoYesIf 'Yes', DescribeList whatever charges there were and disposition (what was the end result?)Are you a Veteran?YesNoIf 'Yes', What Branch?Rental HistoryPrevious AddressPrevious Landlord NamePrevious Landlord PhoneHow long at the previous address?Ever been Evicted?NoYesIf 'Yes', DescribeRental PreferencesOther Adult Occupants? *NoYesIf Yes, each person over 18 must complete a separate application.How many?Any Children? *NoYesHow Many? *Pets? *NoYesIf 'Yes', what kind?How Many Vehicles?012How many registered motor vehicles will be parked regularly at the property?Employment & Income SourcesPrimary Bank NameTypes of AccountsCheckingSavingsCredit Card (Not Debit)Check all that you have with your bank.Ever Filed for Bankruptcy? *NoYesOnly if within the last 10-yearsIf 'Yes', provide Type and Date FiledCurrent Employer Name *Company or if Retired or Disabled, so stateEmployer AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYour Occupation or TitleHow Long?Gross Monthly Income *Manager/Supervisor NameManager PhoneOther Income SourceAmount per MonthPrevious EmploymentOnly required if Current Employment is Less than 2-Years.Previous Employer NamePrevious Employer AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrevious Occupation or TitleHow Long?Gross Monthly IncomePrevious Manager/Supervisor NamePrevious Manager PhonePersonal References3-Required / At least 2 cannot be family Full Name *Relationship *Phone *EmailFull Name *Relationship *Phone *EmailFull NameRelationship *Phone *EmailEmergency ContactEmergency Contact Name *Relationship *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmailPhone *File Upload * Click or drag a file to this area to upload. Upload an image of your State Issued IdentificationApplication Processing & PaymentApplication Fee *Price: $ 50.00Applicant Certification: By signing and submitting this form and paying the Application Fee, I hereby certify that I am at least 18 years of age as the Applicant completing this form. I certify that all information given on this application is true and correct. I hereby authorize verification of all references and facts, including but not limited to current and previous landlords, employers, and personal references. I hereby authorize any owner/agent utilized or authorized by Genesis Opportunity Corporation to obtain any and all Unlawful Detainer, Credit Reports, Telechecks, and/or Criminal Background Reports. I agree to furnish additional credit and/or personal references upon request. I understand that incomplete or incorrect information provided in the application may cause a delay in processing which may result in denial of tenancy. I acknowledge that the Application Fee is not an offer or guarantee of residency and is not refundable. I hereby waive any claim and releases from liability any person providing or obtaining said verification or additional information. Signature *Clear SignatureSign Here using your mouse or finger if touchscreenCredit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2526272829303132333435Total$ 0.00PhonePay Application Fee & Submit