Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
If you voluntarily consent, please provide a statement of any past or present substance abuse (alcohol,
prescription medication, illicit drugs).
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Have you or anyone in your household ever been convicted of a felony? YES NO
If yes, explain:
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Is there anything that would prevent you from obtaining homeowners or renters insurance YES NO
If yes, explain
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Name______________________ Date ___________
Name _______________________________________
Address______________________________________
Phone number________________________________
Relationship__________________________________
How long have you known this person ______________
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Address______________________________________
Phone number________________________________
Relationship__________________________________
How long have you known this person ______________
Name _______________________________________
Address______________________________________
Phone number________________________________
Relationship__________________________________
How long have you known this person ______________
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Phone Number _____________________________
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Phone Number _____________________________
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Phone Number _____________________________
In your own words, please tell why we should choose you for this home
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Name______________________ Date ___________
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Email completed application to operationvictoryky@gmail.com
Or Fax to 502-564-4036