LEASE / RENTAL APPLICATION

Equal Housing Opportunity

The undersigned hereby makes an application to rent the following property:

160 SHERMAN DRIVE, BOILING SPRINGS, SC 29316

MONTHLY RENT - $575
SECURITY DEPOSIT - $ 575

Total MOVE-IN COST - $1,150

(PLEASE USE REVERSE IF ADDITIONAL SPACE IS NEEDED)

Desired/Anticipated Move-In Date _________________

PERSONAL INFORMATION
Full Name_____________________________________________ Phone (
) ________________________
Date of Birth_________________________________ Social Security #__________________________________________
Email Address: __________________________________________
Smoker: Yes_____ No_____
Co-Applicant Name_________________________________________
Co-Applicant Date of Birth______________________ Social Security #__________________________________________
Email Address: __________________________________________
Smoker: Yes_____ No_____
Dependents to be in the Home____________________________________________________________________________
Dependents Date of Birth________________________________________________________________________________
Are Any Dependents Smokers: Yes _____ No _____
List All Requested Pets. *(Pets Not Normally Preferred Negotiable)______________________________________________

PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)

Current Address___________________________________________ City__________________ State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving ____________________________Rent $__________
Owner/Agent__________________________________________________Phone (
) ____________________________
May We Contact? __________
Previous Address _________________________________________________________Rent $____________
Month/Year Moved In______________________ Reasons for Leaving ____________________________Rent $__________
Owner/Agent__________________________________________________Phone (
) ____________________________
Previous Address _________________________________________________________Rent $____________
Month/Year Moved In______________________ Reasons for Leaving ____________________________Rent $__________
Owner/Agent__________________________________________________Phone (
) ____________________________

Rental APPLICATION-FINAL-2015.docx

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PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION PRIOR 3 YRS

Current Employer:
Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________________________
Dates employed_______________________________ Employed as______________________________________________
Supervisor Name______________________________________________ Phone (
) ______________________________
Salary $_________________per________________. Reason for leaving __________________________________________
(If employed by above less than 36 months, give name & phone of previous employer or school)
Prior Employer:
Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________________________
Dates employed_______________________________ Employed as______________________________________________
Supervisor Name______________________________________________ Phone (
) ______________________________
Salary $_________________per________________. Reason for leaving __________________________________________
(If employed by above less than 36 months, give name & phone of previous employer or school)
Prior Employer:
Status: _____Full Time _____Part Time _____Student _____Unemployed
Employer______________________________________________________________________________________________
Dates employed_______________________________ Employed as______________________________________________
Supervisor Name______________________________________________ Phone (
) _____________________________
Salary $_________________per________________. Reason for leaving __________________________________________
(If employed by above less than 36 months, give name & phone of previous employer or school)

OTHER SOURCES OF INCOME:

If you have other sources of income that you to be considered, please list income, source, and person (banker, employer, etc.)
who we may contact for confirmation. You do not have to reveal alimony or child support unless you want us to consider it in this
application.
Amount $___________________ Source/Contact Name ________________________________Phone #_________________

PLEASE LIST YOUR REFERENCES

Personal Reference or Emergency Contact:
Name _______________________ Address _______________________________________________
Phone _______________________ Relationship_______________________
Driver's License:
Your Driver's License Number______________________ State____________
Co-Applicants Drivers License Number ______________State____________
Vehicle Information:
Make / Model _________________Year _________________License Plate_____________ State_________________
Make / Model _________________Year _________________License Plate_____________ State_________________

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PLEASE DESCRIBE YOUR CREDIT HISTORY

Has any applicant declared bankruptcy in the past seven (7) years?
Has any applicant ever been evicted from a rental residence?
Has any applicant ever willfully or intentionally refused to pay rent when due?
Has any applicant ever broken a rental or lease agreement?
Has any applicant had two or more late rental payments in the past year?

Yes___________ No____________
Yes___________ No____________
Yes___________ No____________
Yes___________ No____________
Yes___________ No____________

Please Explain Any Yes Answers:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

ADDITIONAL INFORMATION:
Please give any additional information that might help owner/agent evaluate this application?
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

I authorize and direct property owner or manager to immediately obtain such credit reports, character reports, criminal reports,
verification of rental history and employment history. I further understand that false, fraudulent or misleading information
disclosed or omitted or incomplete information may be grounds of denial of tenancy or subsequent eviction. If this application is
determined to include any false or misleading information, the application will be rejected and Landlord shall retain all application
fees as liquidated damages for Landlords time and expenses in processing this application. Applicant shall submit a nonrefundable Application Processing Fee in the amount of $20. If this Application is returned electronically, the
Application Fee must be mailed to: tdr STUFF, 1641 Battleground Rd., Cowpens, SC 29330 before the Application will
be considered. Checks returned as NSF, Stop Payments or for ANY reason will be subject to a $35 Returned Check Fee
in addition to the Application Fee.
If you enter into a rental agreement with property owner or manager, they have the right to obtain credit reports, criminal reports
and background information on all applicants as long as you are residing in the property.
I recognize that as a part of the procedure for processing my application, an investigative consumer report may be prepared
whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes
information as to my character, general reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true and correct.

Please sign: X__________________________________

Applicant

__________________________________
Date

X__________________________________
Co- Applicant

__________________________________
Date

PLEASE RETURN APPLICATION TO:

tdrrents@outlook.com or contact me to make other arrangements at 864-316-9090
Rental APPLICATION-FINAL-2015.docx

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