Kabien Properties - Rental Agreement

Property address:

PERSONAL INFORMATION (You are on a secure server – all information is kept in complete confidentiality)

First Name	Middle Name	Last Name	Social Security #
DOB	MaritalStatus	Driver's License #	State
Home Phone	Cell Phone	Work Phone	Email
Present Home Address	City/State/Zip	Present Landlord	Present Landlord Phone
Length of Time	Reason for leaving	Present Amount of Rent	Is your rent up to date?
Previous Home Address	Previous City/State/Zip	Previous Landlord	Previous Landlord Phone
Reason for leaving	Length of time	Previous Rent Amount	Was your rent up to date?
Next Previous Home Address	City/State/Zip	Next Previous Landlord	Next Previous Landlord Phone
Reason for leaving	Length of time	Next Previous Rent Amount	Was your rent up to date?

PROPOSED OCCUPANTS

PROPOSED PET(S)

VEHICLE(S) INFORMATION

Year 1		Make		Model		Color		Plate		State
Year 2		Make		Model		Color		Plate		State

EMPLOYMENT

INCOME

CREDIT CARD/FINANCIAL INFORMATION

Car Loan Lienholder	Balance Owed	Monthly Payment	Creditor's Phone Number
Credit Card Company	Balance Owed	Monthly Payment	Creditor's Phone Number
Credit Card Company	Balance Owed	Monthly Payment	Creditor's Phone Number
Credit Card Company	Balance Owed	Monthly Payment	Creditor's Phone Number
Child Support /Other Credit Owed	Balance Owed	Monthly Payment	Other Creditor's Phone Number
Bank Name	Balance	Monthly Payment	Account Number

EMERGENCY/PERSONAL REFERENCE INFORMATION

APPLICANT QUESTIONNAIRE/AUTHORIZATION

Has applicant ever been sued for bills?		Has applicant ever been locked out of their apartment by the sheriff?
Has applicant ever been bankrupt?		Has applicant ever been brought to court by another landlord?
Has applicant ever been guilty of a felony?		Has applicant ever moved owing rent or damaged an apartment?
Has applicant ever broken a lease?		Is the total move-in amount available (rent and deposit)?
Applicant authorizes the landlord to contact past and present landlords, employers, creditors, credit bureaus, neighbors, and any other sources deemed necessary to investigate applicant. All information is true, accurate and complete to the best of applicant's knowledge. Landlord reserves the right to disqualify tenant if information is not represented. ANY PERSON OR FIRM IS AUTHORIZED TO RELEASE INFORMATION ABOUT THE UNDERSIGNED UPON PRESENTATION OF THIS FORM AT ANY TIME.

Applicant Signature (type full name) Signature Date
NOTES

If you have any questions about the interpretation or legality of this form, please consult an attorney or other qualified person.