Rental Application

RENTAL APPLICATION

FIRST NAME ^*

MIDDLE NAME ^*

LAST NAME ^*

PREVIOUS NAMES OR ALIASES ^*

PHONE NUMBER ^*

EMAIL ^*

DATE OF BIRTH ^*

SOCIAL SECURITY NUMBER ^*

DRIVER LICENSE NUMBER ^*

CURRENT STREET ADDRESS ^*

Street, City, Zip Code

CURRENT ADDRESS CITY ^*

CURRENT ADDRESS STATE ^*

LENGTH AT CURRENT ADDRESS ^*

NAME & NUMBER OF CURRENT LANDLORD OR PROPERTY MANAGER ^*

NAME & NUMBER OF PRIOR LANDLORD OR PROPERTY MANAGER ^*

WHY ARE YOU MOVING? ^*

WHAT IS YOUR IDEAL MOVE-IN DATE? ^*

Which property are you interested in? ^*

Magness Street

Converse Street

Woodlawn Ave

WILL ANYBODY ELSE BE LIVING WITH YOU? IF SO, PLEASE LIST THEIR FULL NAME AND RELATIONSHIP TO YOU. ^*

Anyone 18 or older will also need to fill out a separate application.

DO YOU HAVE PETS? ^*

IF YOU HAVE PETS, PLEASE LIST THE KIND, BREED, AND SIZE.

WASHER AND DRYER ^*

DO YOU SMOKE? ^*

HOW MANY VEHICLES WILL BE PARKED AT THE RESIDENCE? ^*

Please list the make and model for each vehicle.

MAKE AND MODEL FOR VEHICLE(S) ^*

HOW DID YOU HEAR ABOUT THIS PROPERTY? ^*

HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR, OR DO YOU CURRENTLY HAVE PENDING CHARGES AGAINST YOU? ^*

HAVE YOU BEEN EVICTED OR ASKED TO VACATE PROPERTY IN THE PAST 7 YEARS? ^*

IF YOU ANSWERED YES TO HAVING A CRIMINAL CONVICTION, PENDING CHARGES, OR AN EVICTION - PLEASE LIST THE NATURE OF THE CRIME, YEAR OF CONVICTION/EVICTION/CHARGE, AND ANY OTHER DETAILS THAT WILL HELP US IN EVALUATING YOUR APPLICATION.

PLACE OF EMPLOYMENT ^*

WORK POSITION/TITLE ^*

EMPLOYMENT TENURE/LENGTH ^*

NAME WORK SUPERVISOR ^*

WORK PHONE NUMBER ^*

MONTHLY INCOME ^*

EMERGENCY CONTACT ^*

Please provide the name and number of who you would want contacted if you had a medical emergency.

PERSONAL REFERENCE #1 ^*

Name & Phone Number

PERSONAL REFERENCE #2 ^*

Name & Phone Number

By completing this application you acknowledge that your employment, residence, landlord, criminal background, credit, income and/or references may be checked and verified and you are authorizing that you allow us to use the information provided to obtain the above verifications. This application does not guarantee rental acceptance. More information may be required for rental evaluation. Due to the volume of applications that we receive, we are only able to respond to applications that meet and pass our requirements and availability. ^*

Submitting this form will serve as an electronic signature for consent to verify any information listed in the application.

Gossett Homes

PO Box 1417

Simpsonville, SC 29681

Fax: 810-815-7586

Email: info@gossettrentals.com