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Rental Application
Rental Application
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Applicant Details
Your 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?
*
No
Yes
If 'Yes', Describe
List whatever charges there were and disposition (what was the end result?)
Are you a Veteran?
Yes
No
If 'Yes', What Branch?
Rental History
Previous Address
Previous Landlord Name
Previous Landlord Phone
How long at the previous address?
Ever been Evicted?
No
Yes
If 'Yes', Describe
Rental Preferences
Other Adult Occupants?
*
No
Yes
If Yes, each person over 18 must complete a separate application.
How many?
Any Children?
*
No
Yes
How Many?
*
Pets?
*
No
Yes
If 'Yes', what kind?
How Many Vehicles?
0
1
2
How many registered motor vehicles will be parked regularly at the property?
Employment & Income Sources
Primary Bank Name
Types of Accounts
Checking
Savings
Credit Card (Not Debit)
Check all that you have with your bank.
Ever Filed for Bankruptcy?
*
No
Yes
Only if within the last 10-years
If 'Yes', provide Type and Date Filed
Current Employer Name
*
Company or if Retired or Disabled, so state
Employer Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Your Occupation or Title
How Long?
Gross Monthly Income
*
Manager/Supervisor Name
Manager Phone
Other Income Source
Amount per Month
Previous Employment
Only required if Current Employment is Less than 2-Years.
Previous Employer Name
Previous Employer Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Previous Occupation or Title
How Long?
Gross Monthly Income
Previous Manager/Supervisor Name
Previous Manager Phone
Personal References
3-Required / At least 2 cannot be family
Full Name
*
Relationship
*
Phone
*
Email
Full Name
*
Relationship
*
Phone
*
Email
Full Name
Relationship
*
Phone
*
Email
Emergency Contact
Emergency Contact Name
*
Relationship
*
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
Phone
*
File Upload
*
Click or drag a file to this area to upload.
Upload an image of your State Issued Identification
Application Processing & Payment
Application Fee
*
Price:
$ 50.00
Applicant 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 Signature
Sign Here using your mouse or finger if touchscreen
Credit Card
*
Card Number
Security Code
Name on Card
Expiration
MM
1
2
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23
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33
Total
$ 0.00
Comment
Pay Application Fee & Submit