AEB

Arizona Rental Application

Premium Student Living

Primary Applicant Information

First Name

Middle Initial

Last Name

Social Security #

Date of Birth

E-mail

Driver License #

DL State / Expiration

Cell Phone Number

Spouse's Information (If Applicable)

First Name

Middle Initial

Last Name

Social Security #

Date of Birth

E-mail

Current Rental History

Current Address

City / State / Zip

Rent Since

Rent Amount

Was your rent on time?

Yes No

Landlord's Name

Landlord Phone

Landlord E-mail

Employment History

Current Employer

Position

Supervisor Name

Supervisor Email

Supervisor Phone

Monthly Salary (Gross)

How long worked there

Other Occupants

Full NameAgeRelationship

Pets

Number of Pets

Type / Breed

Indoor/Outdoor

Name / Age

Vehicle Information

Make / Model

Year / Plate Number

Personal References

Full NameRelationshipE-mailPhone

Legal Disclosures

Has the Applicant or Occupants named in application ever filed for bankruptcy?

Yes No

Has the Applicant or Occupants named in application ever been evicted or had judgment issued?

Yes No

Are there any outstanding judgments against Applicant or Occupants?

Yes No

Has Applicant had property foreclosed upon or given title in lieu in the past 7 years?

Yes No

Has Applicant have pending criminal charges or ever been convicted?

Yes No

Is the Applicant or Occupants named in application party to a lawsuit?

Yes No

Agreement and Authorization

The statements above made are true and correct. Applicant authorizes to conduct a credit check and applicant knows that this is a rental application and not a lease agreement.

Date

Sign by writing your full name

Comments / Notes