Application

RENTAL APPLICATION - DOLAN, REALTORS    
1605 HERITAGE HILLS, WASHINGTON, MO. 63090 Phone: 636-239-7077 Fax: 636-239-7999  
       
APPLICANT INFORMATION:  
Name:_________________________________________ Date of Birth:____________________ Social Security Number:________________  
Present Address (Include City/state/zip)_____________________________________________________Phone:______________________________  
How long at this address:_____________________________ Current Rent:____________________ Current Landlord:_____________________  
Landlord's phone#:_________________________________      
Previous Address:______________________________________  _______________________________ City/State/Zip:_______________________  
How long at this address:______________________________ Rent:__________________________ Landlord:___________________________  
Phone:_______________________________________________ Children's Names:_________________  __________________________________  
       
EMPLOYMENT INFORMATION  
Employer:____________________________________________ Position:________________________ Address:___________________________  
City/State/Zip:________________________________________ Supervisor:______________________ Phone:_____________________________  
How long:_________________________________________ Income:_______________________ (  )Hr   (  )Wk   (  ) Mo  (  )other  
       
CO-APPLICANT INFORMATION  
Name:_____________________________________________ Date of Birth:_____________________ Social Security Number:________________  
Present Address (Include City/state/zip)_____________________________________________________Phone:______________________________  
How long at this address:_______________________________ Current Rent:___________________ Current Landlord:_____________________  
Landlord's phone#_____________________________________      
Previous Address:______________________________________   City/State/Zip:_______________________  
How long at this address:________________________________ Rent:__________________________ Landlord:___________________________  
Phone:_______________________________________________ Children's Names:(if different from above)  
       
EMPLOYMENT INFORMATION  
Employer:____________________________________________ Position:_________________________ Address:____________________________  
City/State/Zip:________________________________________ Supervisor:_______________________ Phone:______________________________  
How long:___________________________________________ Income:________________________ (  )Hr   (  )Wk   (  ) Mo  (  )other  
       
Criminal back ground information: Convicted of a felony? Y or N?  Explain______________________________________________________________  
Activities Date Disposition  
       
       
       
MISCELLANEOUS INFORMATION  
Nearest Relative in-case of Emergency:__________________________________Relationship:________________Phone:_______________________  
Address:_________________________________________________________________________________________________________________  
Automobiles that will occupy parking      
Year: ______        Make/Model: ___________________________  Color:_________________________Lic#____________________State:_______  
Year: _______      Make/Model: __________________________   Color:__________________________ Lic#_________________State:                                            
Number of people to occupy rental:  Adults __________ Children_________________ Total_______________________  
       
PROPERTY INFORMATION:  
Address________________________________________ City/State/Zip_____________________ Monthly Rent Amount $___________/mo.  
Make Checks Payable to: DOLAN, REALTORS Rent effective from the         Day of                 20  
Pro-rate ____________Days to the first, at $_____________Day   $_______________________________  
Deposit Amount:  $_______________________________  
Credit Report Fee $  $_______________________________  
Other $_______________________________  
                                    TOTAL CHARGES $_______________________________  
                                    LESS MONIES RECEIVED $_______________________________  
                                    BALANCE PAYABLE PRIOR TO MOVE IN  ____________________________ $_______________________________  
       
I acknowledge the deposit will not be refunded if this application is not accepted by the owner/agent. If Application is accepted, deposit will not be refunded, but will be applied to the security depost as stated in the lease. I give consent for Dolan Realtors to run a credit report and verify all information I have provided on this application.   
Signature of Applicant:________________________________________________________________ Date:_______________________________  
Signature of Applicant:________________________________________________________________ Date:_______________________________  
(   ) Accepted  (   ) Rejected By   _____________________________ Date:_______________________________