Easy rent Payment

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Please enter your information below. All information provided will be kept safe and secure and will be used to contact you with Rental Payments.

CLIENT CODE: *

MANAGEMENT COMPANY

APARTMENT COMMUNITY

CONTACT NAME

PHONE (XXX-XXX-XXXX)

FAX (XXX-XXX-XXXX)

IN THE EVENT OF CO-RESIDENTS OTHER THAN SPOUSE, USE SEPARATE FORMS FOR EACH APPLICANT *

APPLICANT

CO-APPLICANT

ROOMMATE

COSIGNER

SECTION 8

APPLICANT:

FIRST NAME: *

MIDDLE NAME: *

LAST NAME: *

Social Security Number:
(XXX-XX-XXXX) *

Date of Birth:
(MM/DD/YY) *

SPOUSE:

FIRST NAME:

MIDDLE NAME:

LAST NAME:

Social Security Number:
(XXX-XX-XXXX)

Date of Birth:
(MM/DD/YY)

APARTMENT TO BE OCCUPIED BY (LIST ALL PERSONS): *

OTHER NAMES USED:

DO YOU HAVE ANY PETS? *

TYPE AND NUMBER OF PETS: *

DO YOU HAVE A WATERBED? *

YES

DO YOU HAVE WATERBED INSURANCE?

YES

CURRENT PHONE NUMBER:

EMAIL ADDRESS:

HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENSE? *

YES

HAVE YOU EVER BEEN EVICTED FOR NON PAYMENT OF RENT? *

YES

HAVE YOU EVER DECLARED BANKRUPTCY? *

YES

RESIDENCE HISTORY

APPLICANT'S PRESENT ADDRESS: *

Apt #:

City *

State: *

Zip Code: *

MONTHLY PAYMENT: *

MOVE IN DATE: (MM/DD/YY) *

Type of Residency: *

Mortgage Company

Apartment Community

Private Landlord

Friend or Relative

LANDLORD NAME:

LANDLORD ADDRESS:

LANDLORD PHONE:

EMPLOYMENT HISTORY

APPLICANT EMPLOYED BY: *

PHONE *

POSITION: *

GROSS MONTHLY SALARY: *

START DATE: *

APPLICANT'S PREVIOUS EMPLOYER:

PHONE:

POSITION:

GROSS MONTHLY SALARY:

START DATE:

END DATE:

SPOUSE EMPLOYED BY:

PHONE:

POSITION:

GROSS MONTHLY SALARY:

START DATE:

ADDITIONAL INCOME:

CREDIT AND LOAN REFERENCES

BANK OR SAVINGS AND LOAN:

BRANCH/ADDRESS:

PHONE:

ACCOUNT #:

AUTO (MAKE & MODEL):

LICENSE PLATE #:

STATE

CAR PAYMENT MADE TO:

MONTHLY PAYMENT:

IMPORTANT INFORMATION

NAME OF APPLICANT'S NEAREST RELATIVE: *

RELATIONSHIP *

ADDRESS:

PHONE: *

NAME OF SPOUSE'S NEAREST RELATIVE:

RELATIONSHIP

ADDRESS:

PHONE:

EMERGENCY CONTACT *

RELATIONSHIP *

ADDRESS:

PHONE: *

Reference Name

RELATIONSHIP

PHONE:

Reference Name

RELATIONSHIP

PHONE:

Reference Name

RELATIONSHIP

PHONE:

ATTACH ADDITIONAL DOCUMENTS:

In accordance with State and Federal laws, you are hereby notified that an investigation is being made by easyrentpayment.com using the information you provided on this application, together with information obtained from outside sources. I/We authorize easyrentpayment.com to obtain any credit reports, public records, residential and employment history it deems necessary and to verify all information set forth in the application as well as that obtained by easyrentpayment.com. You have the right to dispute the accuracy of information provided by easyrentpayment.com or by the entities you have disclosed and, upon written request, the right to a complete and accurate disclosure of the nature and scope of the investigation and/or a written summary of your rights under the WA FAIR CREDIT REPORTING ACT. Direct all inquiries to easyrentpayment.com. 121 28 N. Division St. Spokane, WA 99218. I/We understand that false, fraudulent or misleading information disclosed may be grounds for denial of tenancy or subsequent eviction. I hereby release all persons, companies, corporations as well as Bonded Data Research from all liability and responsibility that may results from providing information about me and my history.

***WE COMPLY WITH THE FAIR HOUSING ACT***

Applicant Signature: *

clear

DATE:
(MM/DD/YY)
*

SPOUSE SIGNATURE:

Spouse Signature:

clear

DATE:
(MM/DD/YY)

Report Requested: *

Full Report

Short Report

Cosigner Report

Criminal Only

Report Requested: *

Short Report

Cosigner Report

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