RENTAL APPLICATION

The following sections must be completed by the Applicant. Please note that, except for
married couples, each occupant who is 18 years of age or older has to complete a separate
application to rent.

Shall the Applicant have any question regarding the rental unit, please contact Anthony Bailey
at:
Email Address: _________
Phone: _________

The Applicant is a: (check one)

( ) Tenant
( ) Tenant with co-tenant(s)
( ) Guarantor/co-signor

RENTAL PROPERTY

Application to rent property located at the following address:

5134 Belmore Manor Ct , Suwanee, GA 30024

Type of Property: House

Date of Availability: 12/04/2023
Proposed Move-In Date: 12/05/2023
Type of Lease Term: Fixed Term
Minimum Term of Lease: 1 Year
Monthly Rent Payment: $1,100.00
Initial Security Deposit: $900.00
Applicant has paid the Landlord a non-refundable rental application Fee of: $75.00

APPLICANT'S INFORMATION

Please attach a copy of your Driver's License, State ID, Military ID, or Passport.

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FULL NAME OF APPLICANT:
________________________________________________________________
Date of Birth: _________________________ (Optional. For purpose of obtaining credit
reports. Age discrimination is prohibited by state and federal law)
Social Security Number: _________________________ (Optional)
Driver's license number or any valid ID: _________________ State: ______________
Expires: _________________________
Email Address: ____________________________________________________
Home Phone: (______) ___________ Alternative Phone: (______) ___________

CO-APPLICANT'S INFORMATION (if applicable)

Please attach a copy of your Driver's License, State ID, Military ID, or Passport.

FULL NAME OF CO-APPLICANT:

________________________________________________________________
Date of Birth: _________________________ (Optional)
Social Security Number: _________________________ (Optional)
Driver's license number or any valid ID: _________________ State: ______________
Expires: _________________________
Email Address: ____________________________________________________
Home Phone: (______) ___________ Alternative Phone: (______) ___________

OTHER OCCUPANTS' INFORMATION (if applicable)

Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________ (Optional)

Name: ____________________________________________________________________
Relation to Applicant: ______________________ Date of Birth: ______________ (Optional)

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 EMERGENCY CONTACT

In case of emergency, please contact:

Emergency contact #1: ____________________________________________________

Relationship: _______________________
Address: ____________________________________________________________________
Phone: _______________________
Email Address: ____________________________________________________

Emergency contact #2: ____________________________________________________

Relationship: _______________________
Address: ____________________________________________________________________
Phone: _______________________
Email Address: ____________________________________________________

ADDITIONAL INFORMATION

Pets

The Landlord allows pets in the rental property. However, the following restrictions will apply
to the Applicant:

• The Landlord shall charge the amount of $40.00 for a pet deposit.
• 2 pets under 25lbs each

Does the Applicant own a pet? Yes ( ) No ( )

If the Applicant DOES own a pet, please describe the pet in the following lines:

Number: _____________
Type or Breed: _____________________________________________________
Pet's License, Microchip or Notice Reference Number:
__________________________________________________________________________
Other details:
____________________________________________________________________________
____________________________________________________________________________

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___________________________________________________________________

Parking

The rental unit includes 2 parking space(s) on the premises with the following description:
Driveway

Does the Applicant own a vehicle? Yes ( ) No ( )

Does the Applicant own more than one vehicle? Yes ( ) No ( )

Vehicle 1: (if applicable)

Make: ___________ Model: ___________________ Year: ______

License no.: __________________ State: ______________ Expires: _______

Vehicle 2: (if applicable)

Make: ___________ Model: ___________________ Year: ______

License no.: __________________ State: ______________ Expires: _______

Waterbeds

The Landlord prohibits the use of waterbeds on the rental unit.

Smoking and Vaping

The Landlord does not allow smoking or vaping in the rental unit.

RESIDENCE HISTORY

Current Residence

Current Address: ____________________________________________________________

City/State/Zip: ______________________________________________________________
From: ________________ to ________________
Name of Landlord/Manager: __________________________________________
Landlord/Manager's Phone: __________________________________

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Landlord/Manager's E-mail: __________________________________________
Reason(s) for leaving this address:
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

Previous Residence (if applicable)

Previous Address: ___________________________________________________________

City/State/Zip: ______________________________________________________________
From: ________________ to ________________
Name of Landlord/Manager: __________________________________________
Landlord/Manager's Phone: __________________________________
Landlord/Manager's E-mail: __________________________________________
Reason(s) for leaving this address:
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

Has the Applicant ever been evicted from a rental property

Yes ( ) No ( )
before?
Has the Applicant missed two or more consecutive rental
payments in the past year? Yes ( ) No ( )
Has the Applicant ever refused to pay rent when due? Yes ( ) No ( )

If the Applicant has answered YES to any of the above questions, please state when and why:
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

EMPLOYMENT AND INCOME HISTORY

Current Employment

Current Employer: _________________________________________________________

Current Employer Address: ___________________________________________________
Employment Status: ( ) Full-Time ( ) Part-time ( ) Student ( ) Unemployed ( ) Retired

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From: ________________ to ________________
Supervisor: __________________________________________
Supervisor's Phone: ________________
Supervisor's Email Address: __________________________________________
Employment Gross Income: $ _______________ per __________
Other income information:
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

Previous Employment (if applicable)

Previous Employer: _________________________________________________________

Previous Employer's Address: __________________________________________________
From: ________________ to ________________
Supervisor: __________________________________________
Supervisor's Phone: ________________
Supervisor's Email Address: __________________________________________
Employment Gross Income: $ _______________ per __________
Other income information:
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

PROOF OF INCOME

The Landlord requires proof of income from the Applicant in order to process this rental
application. Please attach a letter from an employer certifying your income or any other
document which can serve as proof of your real income, such as bank statements or true copies
of your IRS tax returns from the previous year.

CREDIT INFORMATION AND BACKGROUND CHECK AUTHORIZATION

Has the Applicant filed for bankruptcy within the last seven (7) years? Yes ( ) No ( )
Does the Applicant consent to a credit check? Yes ( ) No ( )

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 Name of creditor: Account number: Monthly payment: Balance due:

Name of Bank/Branch: Account number: Monthly payment: Balance due:

Does the Applicant wish to comment on anything that we may find out through our credit
check and which could adversely affect his or her application?
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

CRIMINAL BACKGROUND CHECK AUTHORIZATION

Has the Applicant ever been convicted of or pleaded no contest to

a felony? Yes ( ) No ( )
Does the Applicant consent to a criminal background check? Yes ( ) No ( )

Does the Applicant wish to comment on anything that we may find out through our criminal
background check and which could adversely affect his or her application?
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________

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 CONSENT & ACKNOWLEDGEMENT

By signing this Residential Rental Application, the Applicant accepts and agrees to the
following:
(i) This is only an application to rent and does not guarantee that the Applicant will be
selected as a tenant of the premises.
(ii) The Landlord or Manager or his/her authorized Agent could receive multiple rental
applications for the premises and will only select the most qualified individual.
(iii) Applicant represents the above information to be true and complete.

Applicant hereby authorizes the Landlord or Manager or his/her authorized Agent to do the
following:
(i) Verify all of the personal information provided above.
(ii) Obtain a credit report, as well as other reports, on the Applicant.
(iii) Applicant further authorizes the Landlord or Manager or his/her authorized Agent to
disclose information to the owners or agents of the premises with whom the Applicant
intends to have a rental relationship.

Does the Applicant wish to receive a copy of the reports that we

may obtain? Yes ( ) No ( )

Landlord's Tenant Selection Criteria and Warranty of Applicant

Signing this acknowledgement indicates that the Applicant has had the opportunity to review
the tenant selection criteria. The tenant selection criteria includes factors such as criminal
history, credit history, current income, and rental history. If the Applicant does not meet the
selection criteria, or if the Applicant provides inaccurate or incomplete information, or leaves
blank spaces on required information, the application may be rejected.

The Applicant hereby warrants that the information supplied above is complete and accurate
and that the breach of this warranty by the Applicant may result in the termination of any
Lease entered into with the Applicant by the Landlord.

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Reason for Denial

If this Application is denied, the Landlord or Agent shall within ten (10) days thereafter and
upon the written request of Applicant, state the basis for said denial to Applicant.

Notice of Non-Discrimination

The Landlord does not and shall not discriminate on the basis of race, color, religion (creed),
gender, gender expression, age, national origin (ancestry), disability, marital status, sexual
orientation, or military status, in any approval/disapproval of this application.

_______________________________ ___________
Applicant's Signature Date

_______________________________ ___________
Co-Applicant's Signature Date

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