Residential Lease Application

Name*

First

Last

Middle Initial*

Maiden/Other Name(s)*

Date of Birth*

day

/

month

/

year

SSN #*

Phone*

Text Message?*

Email*

Driver's License #*

State*

How many cars, boats, motorcycles, etc. will be kept on the premises?*

Vehicle Description(s)*

License Plate(s) #*

First

Last

Emergency Contact #1 Phone*

Emergency Contact #2*

First

Last

Emergency Contact #2 Phone*

Desired Location*

Maximum Rent*

Are you currently able to provide one month rent plus a security deposit (equal to one month rent)?*

Desired Occupancy Date*

Others Occupying Unit*

Total Occupants Over 18*

Co-Applicant Names:*

Will any smokers occupy the unit?*

Will any pets occupy the unit?*

I acknowledge that smoking is not permitted inside the unit. I acknowledge that smoking inside the unit may result in additional fees upon leaving the unit. *

Pets are not accepted in all locations. I acknowledge that should my pet be accepted, I will be charged a non-refundable pet fee and additional monthly pet rent. *

What pets will occupy the unit?*

Current Address*

Street Address City State / Province / Region Postal / Zip Code

Current Landlord*

First

Last

Current Landlord Phone*

Date Occupied*

What is your reason for leaving?*

Are you currently being evicted?*

Current Rent*

Do any pets occupy the unit?*

Have you complied with all terms of your lease? If not, explain. *

Have you ever been behind on your rent? If so, explain.*

Have you received any complaints from the landlord? *

Previous Address*

Street Address City State / Province / Region Postal / Zip Code

Previous Landlord*

First

Last

Previous Landlord Phone*

Previous Date Occupied *

What was your reason for leaving?*

Were you evicted from this address?*

Previous Rent*

Did any pets occupy the unit?*

Did you comply with all terms of your lease? If not, explain.*

Were you ever been behind on your rent? If so, explain.*

Did you receive any complaints from the landlord? *

Additional Address*

Street Address City State / Province / Region Postal / Zip Code

Additional Landlord*

First

Last

Additional Landlord Phone:*

Additional Date Occupied*

What was reason for leaving this address?*

Did any pets occupy this address?*

Additional Rent*

Were you evicted?*

Did you receive any complaints from this landlord?*

Were you ever been behind on your rent at this address? If so, explain.*

Did you comply with all terms of this lease? If not, explain.*

Do you have any additional addresses to add?*

Additional Addresses*

Have you ever been evicted?*

A complete rental history for the previous FIVE (5) years is required. I acknowledge that failure to provide a complete rental history will result in denial. *

I certify that I have provided a full and complete rental history.*

I authorize verification of my rental history. *

Current Employer*

Employer Phone*

Employer Address*

Street Address City State / Province / Region Postal / Zip Code

I acknowledge that I will be required to submit verification of all income reported. *

Are you able to provide copies of your three (3) most recent pay stubs?*

Supervisor Name*

First

Last

Position Held*

Hire Date*

Monthly Net Income*

Other Income*

Have you ever been slow in payment of rent or any other financial obligation? If so, explain. *

Have you ever declared bankruptcy?*

Is there anything else you would like us to consider in connection with your application?*

I acknowledge that Wellco, LLC does business in accordance with the Fair Housing Act. *

I authorize verification of the information provided on this form as to my rental history, income information, and credit report. I grant permission for Wellco, LLC to obtain a credit report and criminal background report.*

I acknowledge that in order to complete my application, I will have to submit an application fee. The application fee is payable via PayPal or in person at the Wellco, LLC office. The application fee is utilized to complete background and credit checks. Payment is made via our website under the apply tab. I further knowledge of the application fee is non-refundable.*

In connection with my rental application, I understand that my consumer reports which may contain public record information may be requested. These reports may include the following types of information: names and dates of previous employers, public records, credit data, bankruptcy proceedings, election and criminal records, etc., from federal state and other agencies which maintain such records. Additionally, by signing this form I consent to receive marketing and other advertisements by phone and/or email. *

I authorize without reservation, any party or agency contacted by Wellco, LLC to furnish the above mentioned information.*

I understand that if my credit file is access, it will result in a hard credit inquiry. I hereby authorize procurement of consumer reports. If approved as a tenant, this authorization shall remain on file and shall serve as an ongoing authorization for Wellco, LLC to procure consumer reports at any time during my contract period. *

I understand that my application will not be processed until I provide copies of all documents required and submit the application fee. I understand that I must submit a copy of a government issued ID and copies of my three (3) most recent pay stubs and/or benefit letter. Documents may be emailed to leasing@wellcollc.com upon submission.*

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