Application | Benton County Rentals

Rental Application

Property Interested In: *

Anticipated move in date: *

PETS:

Do you have pets? *

The deposit(s) and rent for the property you selected are:

APPLICANT INFORMATION:

Applicant's Name: *

First

Last

Current Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Email

Confirm Email

Phone: *

Work Phone:

Date of Birth: *

SSN # (no dashes):

Driver's License #: *

Applicant's Employment

Name of present employer: *

Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Position: *

Date started: *

Monthly income: *

Supervisor's Name: *

First

Last

Phone:

Previous Employer

Do you have a previous employer? *

Spouse or Co-Applicant

Do you have a spouse or co-applicant? *

Present Landlord or mortgage company:

Present landlord or mortgage company: *

Phone: *

Monthly rent or mortgage payment: *

Date of move-in: *

Date of move-out: *

Previous Landlord or mortgage company:

Do you have a previous Landlord or mortgage company? *

Personal Reference #1:

Name of Personal Reference: *

First

Last

Phone: *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Personal Reference #2:

Name of Personal Reference: *

First

Last

Phone: *

Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact:

In case of emergency contact: *

First

Last

Relationship: *

Phone: *

Occupants:

List all occupants:

List vehicles to be parked at premises:

Make: *

Model: *

Year: *

Make:

Model:

Year:

Credit History

Bank Name: *

Bank Address:

Address Line 1

Address Line 2

City

State

Zip Code

Checking account number: *

List all credit obligations with minimum monthly payment: (if none, type NONE) *

Have any of the occupants listed above ever been:

Convicted of a felony? *

Received a deferred adjudication for a felony? *

Ever been evicted? *

Broken a lease? *

Declared bankruptcy? *

Disclaimer *

I understand the below:

The above listed applicant declares that all statements made in this application are true and complete. Applicant hereby authorizes Horizon Properties, LLC to verify all of the information in this application and obtain credit reports and background checks on the above listed applicant and/or applicants. If applicant or co-applicant provides any false information Landlord is entitled to reject the application, and retain all application fees as liquidated damages for landlord's time and expenses in processing this application. Applicant shall give Landlord a nonrefundable credit application fee in the amount of $30.00 per adult applicant. By clicking submit, I also confirm that I have read and understand the Uniform Standards of Qualifications.

Signature *

Captcha *

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