Application | neofilm

Residential Rental Application

APPLICANT INFORMATION

Name *

Phone *

Date of Birth

Email Address

Driver's License Number *

Current Residence

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Current Monthly Rent *

USD

Lease Start Date *

Lease End Date *

Reason for Leaving *

Landlord's Name *

Phone *

Email Address

Previous Residence

Previous Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Previous Monthly Rent

USD

Lease Start Date

Lease End Date

Reason for Leaving

Landlord's Name

Phone

Email Address

Employment History

Employer *

Occupation *

Start Date *

Gross Monthly Income *

USD

Supervisor's Name *

Supervisor's Phone *

Supervisor's Email

Previous Employer

Employer

Occupation

Start Date

End Date

Gross Monthly Income

USD

Supervisor's Name

Supervisor's Phone

Supervisor's Email

Dependents *Will there be any minor dependents living with you?YesNo

If "Yes", describe:

Pets *Do you have any pets?YesNo

If "Yes", describe:

Public Records *Have you ever been evicted?YesNo

If "Yes", describe:

Bankruptcy *Have you ever filed for Bankruptcy?YesNo

If "Yes", describe:Previous convictions

Criminal Background *Have you ever been convicted of a crime?YesNo

If "Yes", describe:Previous convictions

Personal Reference

Name *

Phone *

Email Address

Who is this personal reference?

CONSENT & ACKNOWLEDGEMENT

I hereby certify that I am at least 18 years of age and that all information given on this application is true and correct. I authorize the Landlord and its agents to obtain an investigative consumer credit
report including but not limited to credit history, OFAC search, landlord/tenant court record search, criminal record search, and registered sex offender search. I authorize the release of information from previous or current landlords, employers, bank representatives, and personal references. I agree to furnish additional credit and/or personal references upon request. I understand incomplete or incorrect information provided in this application may cause a delay in processing which may result in denial of tenancy. This investigation is for resident screening purposes only and is strictly confidential.

Important information about your rights under the Fair Credit Reporting Act:
You have a right to request disclosure of the nature and scope of the investigation. You must be told if information in your file has been used against you. You have a right to know what is in your file, and
this disclosure may be free. You have the right to ask for a credit score (there may be a fee for this service). You have the right to dispute incomplete or inaccurate information. Consumer reporting
agencies must correct inaccurate, incomplete, or unverifiable information.

Consumer Response Center, Room 130-A, Federal Trade Commission, 600 Pennsylvania Avenue N.W.,
Washington D.C. 20580.

In connection with my application for housing, I understand that the property owner/agent may obtain one or more consumer reports, which may contain public information, for the purposes of evaluating
my application. These reports may contain information on my character, general reputation, personal characteristics, and mode of living.

Your submission of this form is in essence your signature indicating that you have read, understand, agree and acknowledge the this information.

PLEASE CONTACT JEFF AT 704-482-9400 TO MAKE SURE THIS APPLICATION WAS RECEIVED OR TO FOLLOW UP.