Unique Choice Rental Application

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Phone: 704.412.1970 Fax: 704.612.0027 Email: info@uniquechoicerealty.com

RENTAL APPLICATION Application Fee (non refundable) $35 each or $60 per married couple (Adults 18 years or older)

Property Address:_____________________________________________________________________

Anticipated Move-In Date: ____________________________________________________________ Applicant Name: ____________________________________________________________________ DOB ______/______/______ Social Security #______/_____/________ Ph.#_____________________ DL/ID # State: ___________________________ Email Address: _______________________________

Co-Applicant Name: _________________________________________________________________ DOB ______/______/______Social Security #______/_____/________ Ph.#_____________________ DL/ID # State: ___________________________ Email Address: _______________________________

Other Occupants Name: __________________________________ Age: _____Relationship: _______________________ Name: __________________________________ Age: _____Relationship: _______________________

Present Address______________________________________________ Yrs. _______ Mths. _______ City: _____________________________________________ State: ________ Zip Code: ___________ Present Landlord: _________________________________________ Ph. # ______________________ Reason for Moving: ___________________________________________________________________

CopyrightŠ2012, Unique Choice Realty, LLC

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Phone: 704.412.1970 Fax: 704.612.0027 Email: info@uniquechoicerealty.com

Previous Address____________________________________________ Yrs. _______ Mths. ________ City: _____________________________________________ State: ________ Zip Code: ___________ Previous Landlord: _________________________________________ Ph. # ______________________ Applicant’s Employer ___________________________________ Supervisor: ___________________ Employer Address_____________________________________________________________________ Ph.# __________________________ Position: _____________________ Salary: __________________ Length of Employment

From _________________ to ____________________

Other Income Type ___________________________________________ Amt: ___________________ If Present Employer Is Less Than 3 Years Complete Below

Applicant’s Employer ___________________________________ Supervisor: ___________________ Employer Address_____________________________________________________________________ Ph.# __________________________ Position: _____________________ Salary: __________________ Length of Employment

From ________________ to ________________

Co-Applicant’s Employer __________________________________ Supervisor: _________________ Employer Address_____________________________________________________________________ Ph.# __________________________ Position: _____________________ Salary: __________________ Length of Employment

From _________________ to ____________________

Other Income Type ___________________________________________ Amt: ___________________

Copyright©2012, Unique Choice Realty, LLC

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Phone: 704.412.1970 Fax: 704.612.0027 Email: info@uniquechoicerealty.com

Has Applicant, Co-Applicant or Proposed Resident Ever: Been Evicted: Yes ____ No ____

Filed Bankruptcy Yes ____ No ____

Intentionally refused to pay rent Yes ____ No ____ Been convicted of a misdemeanor or felony other than traffic violation Yes ____ No ____ If yes, please explain: __________________________________________________________________ ____________________________________________________________________________________ Pets: Yes ____ No ____ Kind: ____________________________________ Weight: _______________

Emergency Contact Name: ______________________________ Relationship:___________ Ph.# _____________________

Character References (Relatives excluded) Name: ________________________________ Relationship: ____________ Ph. # _________________ Years Known _____ Name: ________________________________ Relationship: ____________ Ph. # _________________ Years Known _____ Name: ________________________________ Relationship: ____________ Ph. # _________________ Years Known _____

CopyrightŠ2012, Unique Choice Realty, LLC

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Phone: 704.412.1970 Fax: 704.612.0027 Email: info@uniquechoicerealty.com

Consent To Obtain Credit/Criminal/Employment History I/We authorize Unique Choice Realty, LLC, to investigate my/our credit worthiness contact present and previous employers and landlords and further by a copy of this application authorizes any said employer or landlord release any pertinent employment or residential history information to be used in evaluating my lease application. I further authorize owner/landlord, leasing agent or its representatives to apply for or obtain an investigation or credit report in connection with this application. I/We understand that said investigation or credit report may contain information obtained from various states, governmental and private entities relative to the undersigned’s number of children, employment, occupation, general health financial and criminal history information and hereby release, in any manner, all of the information obtained by you. I/We further release all persons, agencies, or firms from any liabilities resulting from providing such information. I/We declare under penalty of perjury that all information listed in the application is true and correct.

____________________________________________________________ Applicant’s Signature

_____________________ Date

____________________________________________________________ Co- Applicant’s Signature

_____________________ Date

For office use only

Application fee received ______/______/______ Amt: ________ Approved: ______ Rejected: _______ Security Deposit received ______/______/______ Amt: ________ Comments: _______________________________________________________________________ Leasing Agents Initial’s ___________ Copyright©2012, Unique Choice Realty, LLC 4|Page


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